Hysteroscopic surgery is a minimally invasive procedure for the treatment of intrauterine pathologies. However, it can result in fatal complications. We herein report a case of symptomatic hyponatremia and hyperglycemia during hysteroscopic resection of severe intrauterine adhesion with 5% dextrose in water as the distension medium. Because of the difficulty of the incision, the infusion pressure was 100 to 150 mmHg, and surgery was continued for 70 minutes. A total of 19 L of 5% dextrose in water was used as an irrigating fluid. Large-scale absorption of irrigating fluid (3 L) induced dilutional hyponatremia (120 mmol/L) and hyperglycemia (30 mmol/L). Initial signs were abnormal flatulence and postoperative coma. Hypertonic saline, diuretics, insulin, and liquid restriction were the prevailing treatment strategies for hyponatremia and hyperglycemia. Ionized calcium and potassium levels decreased during treatment. We emphasize the importance of prevention, recognition, and a meticulous perioperative treatment standard. Surgical teams must be vigilant in fluid deficit monitoring and serum electrolyte analysis.
Adult ; Female ; Humans ; Hyperglycemia ; etiology ; Hyponatremia ; etiology ; Hysteroscopy ; adverse effects ; Intraoperative Complications ; etiology ; Tissue Adhesions ; Uterine Diseases ; surgery

OBJECTIVETo evaluate a new technique for treatment of the symblepharon caused by physical and chemical burn.

METHODSThirty-eight patients with 40 eyes were undergoing the treatment. It was carried out to reconstruct the conjunctival fornix by pulling the remained conjunctive backward from the corneal limbus in serious stages.

RESULTSThirty-eight patients (40 eyes) were treated with this technique, with the successful results of 13 patients (13 eyes) in 2 times, 19 patients (21 eyes) in 3 and 6 patients (6 eyes) in 1. Only one case was failure.

CONCLUSIONThe above mentioned technique could be a safe and effective way for treatment of symblepharen.

Amnion ; Conjunctival Diseases ; etiology ; therapy ; Eye Burns ; complications ; Eyelid Diseases ; etiology ; therapy ; Humans ; Reconstructive Surgical Procedures ; Tissue Adhesions ; etiology ; therapy

The pathogenesis and therapeutic treatment of intrauterine adhesions (IUAs) remain unsolved, highlighting the need for stable and effective experimental animal models. In this study, uterine electrocoagulation of twenty-one female New Zealand White rabbits was carried out to establish an IUA model. As rabbits have two completely separate uterine horns, each rabbit had its own internal control: one uterine horn was given an electrothermal injury (Group A, n=21), and the contralateral uterine horn received no treatment and served as the control (Group B, n=21). The endometrial morphology, number of endometrial glands, area of endometrial fibrosis, and number of implanted fetuses were compared between the two groups. In Group A, the numbers of endometrial glands on Days 7 and 14 and the number of implanted fetuses were significantly lower than those in Group B (P<0.05, P<0.05, and P<0.01, respectively), while the ratio of the area with endometrial stromal fibrosis to the total endometrial area was significantly increased (P<0.01). These results suggest that this method of electrothermal injury is effective for the establishment of a rabbit IUA model between 7 and 14 d after surgery.
Animals ; Disease Models, Animal ; Electrocoagulation ; Endometrium ; pathology ; Female ; Pregnancy ; Rabbits ; Tissue Adhesions ; etiology ; pathology ; therapy ; Uterine Diseases ; etiology

Post-operative adhesions are a common complication of pelvic and abdominal surgeries. Many approaches for preventing post-operative adhesions have been developed. This review summarizes the recent advances in this topic.
Abdomen ; surgery ; Biomedical and Dental Materials ; Humans ; Pelvis ; surgery ; Postoperative Complications ; prevention & control ; Tissue Adhesions ; etiology ; prevention & control

OBJECTIVETo establish a rabbit double uterine horn model for assessing the time-course of pelvic adhesions and evaluating the effectiveness of different anti-adhesive materials in reducing adhesions.

METHODSA total of 330 Japanese white rabbits underwent laparotomy, followed by uterine horn incision. Animals were euthanized after 3, 7, 14, 28, and 42 days, respectively.

RESULTSThe surgical procedure was smooth. Rabbit double uterine horn model was applied for the evaluation of pelvic adhesions in a three-dimension fashion. Each of the three means-gauze abrasion, needle holder clamping, and direct uterine incision induced postoperative pelvic adhesions, among which direct uterine incision was the best to mimic conditions after gynecological operations. Under normal circumstances, degradation of filmy fibrinous adhesions by locally released proteases of the fibrinolytic system occurred within 3 days of injury. The regeneration of the mesothelium was completed within 7 days. Collagen reached its peak by day 14. Anti-adhesive materials were supposed to be completely absorbed by day 28, and their effectiveness in preventing pelvic adhesions was confirmed at this time point. Whether their effect can be maintained after the absorption of the anti-adhesive materials was investigated in 42 days.

CONCLUSIONSThe animal model was successfully established. It well mimics the postoperative pelvic adhesions after direct uterine horn injury and thus is a suitable model for studying site-specific adhesions. Observations on the 3rd, 7th, 14th, 28th, and 42nd post-operative days provided a full picture of the adhesion formation process.

Animals ; Biocompatible Materials ; Disease Models, Animal ; Female ; Laparotomy ; Postoperative Complications ; prevention & control ; Rabbits ; Tissue Adhesions ; etiology ; prevention & control ; Uterus ; surgery

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Ileus ; complications ; Intestinal Diseases ; etiology ; pathology ; therapy ; Tissue Adhesions ; pathology ; therapy

OBJECTIVE: To depict the cell landscape and molecular biological characteristics of human intrauterine adhesion (IUA) so as to better understand its immune microenvironment and provide new inspirations for clinical treatment. METHODS: Four patients with IUA who underwent hysteroscopic treatment at Dongguan Maternal and Child Health Care Hospital from February 2022 to April 2022 were selected as the study subjects. Hysteroscopy was used to collect the tissues of IUA, which were graded based on the patient's medical history, menstrual history and status of IUA. Library construction, sequencing, single cell data comparison and gene expression matrix construction were carried out in strict accordance with the single cell RNA sequencing process. Thereafter, the UMAP dimension reduction analysis of cell population and genetic analysis were carried out based on the cell types. RESULTS: A total of 27 511 cell transcripts were obtained from four moderately graded IUA tissue samples and assigned to six cell lineages including T cells, mononuclear phagocytes, epithelial cells, fibroblasts, endothelial cells and erythrocytes. Compared with normal uterine tissue cells, the four samples showed different cell distribution, and the proportions of mononuclear phagocytes and T cells in sample IUA0202204 were significantly increased, suggesting a strong cellular immune response. CONCLUSION The cell diversity and heterogeneity of moderate IUA tissues have been described. Each cell subgroup has unique molecular characteristics, which may provide new clues for further study of the pathogenesis of IUA and heterogeneity among the patients.
Pregnancy ; Female ; Child ; Humans ; Endothelial Cells ; Uterine Diseases/complications* ; Hysteroscopy/methods* ; Tissue Adhesions/etiology* ; Sequence Analysis, RNA

There is a lack of clinical and experimental studies of the treatment of incompletely transected tendons. The controversy concerning the source of flexor tendon nutrients is of important clinical concern in healing of the injured tendon; thus, the flexor tendon blood supply has cited as a reason for using specific tendon suture techniques, and as a rationale for preserving the superficialis tendon and its vincula during tendon repair surgery. Our knowledge of the normal physiology of digital flexor tendons and the mechanism of their healing process is deficient. The aim of this study was to investigate the relative importance of the synovial fluid and the blood supply respectively for the healing of partially severed flexor tendons. We observed the sequential histological and vascular changes which occur in healing of the partial lacerations in the dorsal and plantar aspects of the tendons. We observed the vascularities of the two partially severed tendon groups after injection of microfil and india ink through the femoral artery. In the healing process there was no sequential histological difference between the dorsal and the plantar severed tendons. The vascularity patterns of the healing tendons were significantly increased and the hypervascularity of dorsal severed tendons was greater than that of plantar severed tendons. Partially severed tendons were completely healed without surgical repair with dense collagen fibers without adhesion in most cases. We concluded from this study that the blood vessels appeared to play a significant role in the healing of the severed flexor tendons. An intact synovial environment did not seem to be required for healing of the severed tendon. It is not necessary to surgically repair the partially severed tendon for prevention of rupture and adhesion.
Adhesions/etiology ; Animal ; Chickens ; Comparative Study ; Support, Non-U.S. Gov't ; Synovial Fluid/physiology ; Tendon Injuries/*physiopathology ; Tendons/blood supply ; *Wound Healing

OBJECTIVETo assess the abdominal cocoon complicated with infertility using laparoscope and its clinical management.

METHODSSix cases of abdominal cocoon treated in our hospital from January 1998 to December 2002 were retrospectively reviewed.

RESULTSOf the 6 patients all with primary and tubal infertility, 3 received routine closed laparoscope operation, and other 3 failed for laparoscopy and were transferred to laparotomy. During the surgery it was found that the abdomen and pelvis were filled with multiple layer fibrous tissue which enveloped the bowel and reproductive organs, making exploration nearly impossible. It was difficult to ablate the envelope.

CONCLUSIONAbdominal cocoon can be diagnosed in those primary and tubal infertile patients when the charge is hindered in the process of laparoscope. The optimal treatment of the infertility for those patients is in vitro fertilization-embryo transfer.

Adult ; Female ; Fibrosis ; complications ; Humans ; Infertility, Female ; etiology ; Intestinal Obstruction ; diagnosis ; Intestine, Small ; pathology ; Laparoscopy ; Peritoneal Diseases ; complications ; Tissue Adhesions ; complications

OBJECTIVEAdhesive or too highly located folds upper eyelid and even blepharoptosis are common complications of double eyelid operation. To correct such deformities.

METHODWe shifted down the double eyelid line, removed adhesion thoroughly, relieved orbital fat and restarted the volume with infraorbicularis oculi fat flap.

RESULTWe had treated 32 case in past two years. The results were satisfying.

CONCLUSIONThe method are acted easy and gained fine result, so behaving to extend application.

Adipose Tissue ; transplantation ; Adult ; Blepharoplasty ; methods ; Eye Abnormalities ; etiology ; surgery ; Eyelids ; abnormalities ; pathology ; Female ; Humans ; Oculomotor Muscles ; surgery ; Postoperative Complications ; surgery ; Tissue Adhesions ; Young Adult