1.Rudimentary horn pregnancy: clinical analysis of 12 cases and literature review.
Ming Mei LIN ; Yi Meng GE ; Shuo YANG ; Rui YANG ; Rong LI
Chinese Journal of Obstetrics and Gynecology 2024;59(1):49-55
Objective: To investigate the clinical characteristics, treatments and fertility recovery of rudimentary horn pregnancy (RHP). Methods: The clinical data of 12 cases with RHP diagnosed and treated in Peking University Third Hospital from January 1, 2010 to December 31, 2022 were retrospectively analyzed. Clinical informations, diagnosis and treatments of RHP and the pregnancy status after surgery were analyzed. Results: The median age of 12 RHP patients was 29 years (range: 24-37 years). Eight cases of pregnancy in residual horn of uterus occurred in type Ⅰ residual horn of uterus, 4 cases occurred in type Ⅱ residual horn of uterus; among which 5 cases were misdiagnosed by ultrasound before surgery. All patients underwent excision of residual horn of uterus and affected salpingectomy. After surgery, 9 patients expected future pregnancy, and 3 cases of natural pregnancy, 2 cases of successful pregnancy through assisted reproductive technology. Four pregnancies resulted in live birth with cesarean section, and 1 case resulted in spontaneous abortion during the first trimester of pregnancy. No uterine rupture or ectopic pregnancy occurred in subsequent pregnancies. Conclusions: Ultrasonography could aid early diagnosis of RHP while misdiagnosis occurred in certain cases. Thus, a comprehensive judgment and decision ought to be made based on medical history, physical examination and assisted examination. Surgical exploration is necessary for diagnosis and treatment of RHP. For infertile patients, assisted reproductive technology should be applied when necessary. Caution to prevent the occurrence of pregnancy complications such as uterine rupture, and application of cesarean section to terminate pregnancy are recommended.
Pregnancy
;
Humans
;
Female
;
Young Adult
;
Adult
;
Cesarean Section/adverse effects*
;
Retrospective Studies
;
Pregnancy, Ectopic/surgery*
;
Pregnancy, Cornual/surgery*
;
Uterus/surgery*
;
Uterine Rupture/etiology*
;
Abortion, Spontaneous
2.Double trouble in an ectopic pregnancy
Shalini Singh ; Vandana Kamatham ; Sharmila Vijayan ; Prashant Joshi
Philippine Journal of Obstetrics and Gynecology 2023;47(6):329-332
Gestational trophoblastic diseases are histologically different types of tumors originating from the
placenta with an incidence of 0.2–5.8/1000 pregnancies. Ectopic pregnancy is the implantation of
the fertilized ovum outside the uterine cavity, and a 0.64% incidence is reported. Ectopic cornual
pregnancy and molar pregnancy are rare cases, and a combination of these two rare entities occurring
simultaneously is even rare and very few cases have been reported in the literature. A cornual
pregnancy refers to the implantation and development of a gestational sac in one of the upper and
lateral portions of the uterus, whereas an interstitial pregnancy is a gestational sac that implants
within the proximal, intramural portion of the fallopian tube that is enveloped by the myometrium. We
present one of the rare combinations of molar pregnancy and cornual/interstitial ectopic pregnancy
in a 30‑year‑old G3
P1
who presented with a triad of amenorrhea, vaginal bleeding, and abdominal
pain. Laparotomy was done in view of an ultrasound which was suggestive of a well‑defined complex
thick‑walled lesion of size 3.2 × 3.3 with a gestational sac and no cardiac activity in the right fallopian
tube/adnexa suggesting tubal ectopic pregnancy. Beta‑human chorionic gonadotropin (β‑hCG) levels
were done and noted to be as high as 9998 mIU/mL. Intraoperatively, a cornual ectopic pregnancy was
found with no hemoperitoneum which was excised. Histopathology showed chorionic villi with variable
size and hydropic change, myxoid stromal changes, and cistern formation with polar trophoblastic
proliferation, based on which a diagnosis of molar pregnancy was made. Although ultrasonography
and higher than usual serum β‑hCG levels are diagnostic of uterine molar pregnancy, they do not
yield a proper diagnosis in ectopic molar pregnancy, hence, making it difficult to distinguish between
an early ectopic molar pregnancy from a nontrophoblastic tubal pregnancy. The final diagnosis is
usually made only after histopathology. A high degree of clinical suspicion of cornual pregnancy
followed by histopathological examination of the products of conception is the standard for arriving
at an appropriate diagnosis. Serial serum β‑hCG level follow‑up is recommended to rule out its
malignant potential.
Pregnancy, Cornual
;
Pregnancy, Ectopic
;
Hydatidiform Mole
4.Experts' consensus on ectopic eruption of the maxillary permanent first molar.
Chinese Journal of Stomatology 2022;57(3):213-219
Ectopic eruption of the maxillary permanent first molar refers to its deviation from the normal position due to some factors during the eruption process, which will lead to root resorption and early loss of the adjacent second primary molar, mesial movement itself, or serious malocclusion. To solve these problems, the Society of Pediatric Dentistry of Chinese Stomatological Association organized pediatric dental experts from 16 universities and hospitals, including West China Hospital of Stomatology, Sichuan University, Peking University School and Hospital of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine to carry out a panel discussions. The research, and diagnosis and treatment experiences of ectopic eruption of maxillary permanent first molar at home and abroad in recent years were also referred to. The present guideline was eventually developed for the reference of dental clinicians.
Child
;
China
;
Consensus
;
Humans
;
Maxilla
;
Molar
;
Tooth Eruption, Ectopic/therapy*
5.Primary vaginal gestational trophoblastic neoplasia treated with uterine angiographic embolization and Etoposide, Methotrexate, Actinomycin D, Cyclophosphamide, and Vincristine: Philippines’ first reported case
Maria Concepcion D. Cenizal‑Santos ; Angelica Anne A. Chua ; Leo Francis N. Aquilizan
Philippine Journal of Obstetrics and Gynecology 2022;46(4):177-181
Gestational trophoblastic neoplasia (GTN) in itself is an uncommon condition, much so is primary extrauterine GTN. The incidence of GTN in the Philippines is at 22.4/40,000 pregnancies. However, no report has been made for primary extrauterine GTN. Only two cases of primary vaginal choriocarcinoma are reported in literature. This is a case of a 26 year old G1P0 (0010) who came in for profuse vaginal bleeding. Serum beta‑human chorionic gonadotropin (β‑hCG) was elevated and ultrasound showed hypervascular vaginal mass and an empty uterus. A primary vaginal GTN was considered and the patient was treated with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMACO) regimen. During the course of chemotherapy, there was a note of profuse vaginal bleeding which was controlled by angiographic uterine artery embolization. A normal β‑hCG level was achieved after six cycles of EMACO. The patient was able to have three successful pregnancy outcomes thereafter. Primary vaginal GTN is a rare condition that requires a high index of suspicion. In a nulliparous patient complicated with profuse vaginal bleeding, angiographic embolization is an effective fertility‑sparing procedure that can manage the said complication.
Trophoblastic Neoplasms
;
Embolization, Therapeutic
;
Pregnancy, Ectopic
6.Ectopic expression of the AmDREB1F gene from Ammopiptanthus mongolicus enhances stress tolerance of transgenic Arabidopsis.
Kuangang TANG ; Bo DONG ; Xiaojun WEN ; Yumei YIN ; Min XUE ; Zixian SU ; Maoyan WANG
Chinese Journal of Biotechnology 2021;37(12):4329-4341
Dehydration-responsive element binding proteins (DREBs) are an important class of transcription factors related to plant stress tolerance. Ammopiptanthus mongolicus is an evergreen broadleaf shrub endemic to desert areas of northwest China, and it has a very high tolerance to harsh environments. In order to reveal the functions and mechanisms of the AmDREB1F gene from this species in enduring abiotic stresses, we performed subcellular localization test, expression pattern analysis, and stress tolerance evaluation of transgenic Arabidopsis harboring this gene. The protein encoded by AmDREB1F was localized in the nucleus. In laboratory-cultured A. mongolicus seedlings, the expression of AmDREB1F was induced significantly by cold and drought but very slightly by salt and heat stresses, and undetectable upon ABA treatment. In leaves of naturally growing shrubs in the wild, the expression levels of the AmDREB1F gene were much higher during the late autumn, winter and early spring than in other seasons. Moreover, the expression was abundant in roots and immature pods rather than other organs of the shrubs. Constitutive expression of AmDREB1F in Arabidopsis induced the expression of several DREB-regulated stress-responsive genes and improved the tolerance of transgenic lines to drought, high salinity and low temperature as well as oxidative stress. The constitutive expression also caused growth retardation of the transgenics, which could be eliminated by the application of gibberellin 3. Stress-inducible expression of AmDREB1F also enhanced the tolerance of transgenic Arabidopsis to all of the four stresses mentioned above, without affecting its growth and development. These results suggest that AmDREB1F gene may play positive regulatory roles in response to abiotic stresses through the ABA-independent signaling pathways.
Arabidopsis/metabolism*
;
Droughts
;
Ectopic Gene Expression
;
Fabaceae/genetics*
;
Gene Expression Regulation, Plant
;
Plant Proteins/metabolism*
;
Plants, Genetically Modified/genetics*
;
Stress, Physiological/genetics*
7.Ectopic Cushing’s Syndrome secondary to Recurrent Thymic Neuroendocrine Carcinoma with Bilateral Ovarian Metastases: A case report
Eunice Yi Chwen Lau ; Zanariah Hussein
Journal of the ASEAN Federation of Endocrine Societies 2021;36(1):98-102
Cushing’s syndrome due to ectopic adrenocorticotrophic hormone (ACTH) secretion is uncommon, accounting for 9 to 18% of cases; approximately 10% of ACTH producing tumours are caused by thymic carcinomas.1 We describe a young lady who presented with Cushing’s syndrome secondary to a primary neuroendocrine tumour (NET) arising from the thymus. She had surgical resection of her primary tumour with remission of her Cushing’s syndrome however subsequently went on to have locoregional recurrence followed by distant metastases to her bilateral ovaries. She underwent 6 surgeries including bilateral adrenalectomy and had 3 cycles of chemotherapy over the course of the 8 years since her diagnosis. Due to the rarity and highly aggressive nature of this disease, we highlight the need for a multidisciplinary team approach and use of multiple modalities in the management of our patient. Timely use of bilateral adrenalectomy particularly in young patients is important to prevent further complications and facilitate other treatment modalities.
Adrenalectomy
;
ACTH Syndrome, Ectopic
8.Not Available.
Journal of Forensic Medicine 2021;37(5):706-707
9.Term, live, primary ovarian pregnancy: A case report
Mary Menuro F. Acda ; Agnes L. Soriano-Estrella
Philippine Journal of Obstetrics and Gynecology 2020;44(5):29-32
Primary ovarian pregnancy accounts for less than 1% of all cases of ectopic pregnancies. Its diagnosis is most commonly made intra-operatively and the approach in its management has been geared towards conservative measures such as oophorectomy and resection. Use of intrauterine device still remains the most established risk factor for the development of ovarian pregnancy. The diagnosis is established following the criteria first described by Spiegelberg in 1878. Several cases of ovarian gestation have been described in literature, although very few cases with live term fetus have been reported. Majority of the cases were diagnosed intra-operatively, and the management was tailored depending on the complexity of each of the different cases. This paper reports a case of primary ovarian pregnancy with a live term fetus, which was only diagnosed intra-operatively. Total hysterectomy with right salpingo-oophorectomy was performed due to difficulties encountered brought about by dense adhesions.
Pregnancy
;
Female
;
Pregnancy, Ectopic
;
Pregnancy, Ovarian
;
10.Ectopic expression of archaeal TRAM-encoding genes in rice improves its drought-tolerance.
Wei CHEN ; Huali LI ; Jinlong QIU
Chinese Journal of Biotechnology 2019;35(9):1676-1685
Drought stress affects the growth and development of rice, resulting in severe loss in yield and quality. Ectopic expression of the bacterial RNA chaperone, cold shock protein (Csp), can improve rice drought tolerance. Archaeal TRAM (TRM2 and MiaB) proteins have similar structure and biochemical functions as bacterial Csp. Moreover, DNA replication, transcription and translation of archaea are more similar to those in eukaryotes. To test if archaeal RNA chaperones could confer plant drought tolerance, we selected two TRAM proteins, Mpsy_3066 and Mpsy_0643, from a cold-adaptive methanogenic archaea Methanolobus psychrophilus R15 to study. We overexpressed the TRAM proteins in rice and performed drought treatment at seedling and adult stage. The results showed that overexpression both TRAM proteins could significantly improve the tolerance of rice to drought stress. We further demonstrated in rice protoplasts that the TRAMs could abolish misfolded RNA secondary structure and improve translation efficiency, which might explain how TRAMs improve drought tolerance transgenic rice. Our work supports that ectopic expression of archaeal TRAMs effectively improve drought tolerance in rice.
Droughts
;
Ectopic Gene Expression
;
Gene Expression Regulation, Plant
;
Oryza
;
Plant Proteins
;
Plants, Genetically Modified
;
Stress, Physiological


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