Anterior abdominal wall leiomyoma arising de novo in a perimenopausal woman.
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ABSTRACT:
SUBMITTER: Al-Wadaani HA
PROVIDER: S-EPMC3464739 | biostudies-other | 2012 Jul
REPOSITORIES: biostudies-other
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Project description:Intra-leiomyoma hemorrhage in postmenopausal woman is a very rare complication. This case report represents a case report of spontaneous hemorrhage inside the uterine leiomyoma in postmenopausal woman who presented with acute abdomen. A 55-year-old woman, multipara, postmenopausal for 7 years, known case of multiple fibroid uteruses, was presented to the emergency department of Ahmadi Hospital, Kuwait Oil Company, with acute abdominal pain and vomiting, without any reported trauma and/or associated vaginal bleeding. The studied woman was generally stable regarding her vital signs, her hemoglobin dropped from 12 to 10.2 g/dl. Abdominal examination revealed; palpable pelvi-abdominal mass firms in consistency with tenderness and guarding which provisionally support the diagnosis of degenerated fibroids or intra-leiomyoma hemorrhage. The diagnosis was confirmed by basic pelvi-abdominal ultrasound, followed by correction of the patient's general condition and total abdominal hysterectomy with bilateral salpingo-oophrectomy (TAHBSO). Bisected largest cystic fibroid showed brownish serous fluid inside with organized clotted hematoma which confirmed the diagnosis of intra-leiomyoma hemorrhage. Postoperatively, the studied woman received an unit of packed red blood cells for correction of the postoperative anemia and discharged from the hospital in good general condition for postoperative follow-up in the outpatients' department on iron tablets. This case report represents a rare complication of intra-leiomyoma hemorrhage in postmenopausal, diagnosed by the basic clinical and ultrasound findings. The case was managed by TAHBSO after correction of the general condition because of the increased risk of the sarcomatous changes of the uterine fibroid in postmenopausal women.
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Project description:The treatment of ventral hernias (VH) has been a challenging problem for medical care. Repair of these hernias is fraught with failure; recurrence rates ranging from 24% to 43% have been reported, even with the use of biocompatible mesh. Currently, computed tomography (CT) is used to guide intervention through expert, but qualitative, clinical judgments, notably, quantitative metrics based on image-processing are not used. The authors propose that image segmentation methods to capture the three-dimensional structure of the abdominal wall and its abnormalities will provide a foundation on which to measure geometric properties of hernias and surrounding tissues and, therefore, to optimize intervention.In this study with 20 clinically acquired CT scans on postoperative patients, the authors demonstrated a novel approach to geometric classification of the abdominal. The authors' approach uses a texture analysis based on Gabor filters to extract feature vectors and follows a fuzzy c-means clustering method to estimate voxelwise probability memberships for eight clusters. The memberships estimated from the texture analysis are helpful to identify anatomical structures with inhomogeneous intensities. The membership was used to guide the level set evolution, as well as to derive an initial start close to the abdominal wall.Segmentation results on abdominal walls were both quantitatively and qualitatively validated with surface errors based on manually labeled ground truth. Using texture, mean surface errors for the outer surface of the abdominal wall were less than 2 mm, with 91% of the outer surface less than 5 mm away from the manual tracings; errors were significantly greater (2-5 mm) for methods that did not use the texture.The authors' approach establishes a baseline for characterizing the abdominal wall for improving VH care. Inherent texture patterns in CT scans are helpful to the tissue classification, and texture analysis can improve the level set segmentation around the abdominal region.
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Project description:ObjectiveTo evaluate the likelihood of developing de novo erectile dysfunction (ED) after anterior urethroplasty and to determine if this likelihood is influenced by age, stricture length, number of previous procedures or timing of evaluation.Materials and methodsPubMed, Embase, Cochrane, and Google Scholar databases were searched for the terms 'urethroplasty', 'urethral obstruction', 'urethral stricture', 'sexual function', 'erection', 'erectile function', 'erectile dysfunction', 'impotence' and 'sexual dysfunction'. Two reviewers evaluated articles for inclusion based on predetermined criteria.ResultsIn a meta-analysis of 36 studies with a total of 2323 patients, de novo ED was rare, with an incidence of 1%. In studies that assessed postoperative erectile function at more than one time point, ED was transient and resolved at between 6 and 12 months in 86% of cases.ConclusionsMen should be counselled regarding the possibility of transient or permanent de novo ED after anterior urethroplasty procedures. Increasing mean age was associated with an increased likelihood of de novo ED, but this was not statistically significant.
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Project description:BackgroundThe 18p terminal deletion with inverted duplication is an extremely rare chromosome structure abnormality and the common clinical manifestations include intellectual disability and speech delay, etc. Up to now, only three confirmed cases were reported in Europe, and here, for the first time in the Asian population, we report a case of de novo 18p inv-dup-del in a Chinese pregnant woman. This structural variation was accidentally discovered by the noninvasive prenatal testing (NIPT) during her prenatal examination.MethodsNext generation sequencing (NGS) based copy number variations (CNVs) screening and karyotype analysis were performed to verify the type and heredity of the rearrangement, and the fluorescent in situ hybridization (FISH) analysis was also used to confirm the terminal deletion and inverted duplication.ResultsThe patient has a de novo 18p11.31-18p11.1 inverted duplication with a 6.2 Mb 18p terminal deletion. This rare chromosome imbalance, most likely caused by the U-type exchange mechanism, resulted in the aberrant phenotype of mental disability, speech delay, seizure, and strabismus. However, the rearrangement was not inherited by her unborn child.ConclusionThis report added a new type of variation to the spectrum of 18p terminal deletion with inverted duplication, and demonstrated that the maternal chromosome rearrangement discovered in NIPT should not just be consider as an interference factor but also a potential indicator of previously undiscovered pathogenic chromosome structure variations in pregnant women.
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