Journal of Nanjing Medical University最新文献

{"title":"A prospective study: intraoperative 125I radioactive seed implant therapy in advanced esophageal squamous cell carcinoma","authors":"Jin Lü, Xiu-feng Cao, B. Zhu, Lü Ji","doi":"10.1016/S1007-4376(09)60080-0","DOIUrl":"https://doi.org/10.1016/S1007-4376(09)60080-0","url":null,"abstract":"","PeriodicalId":100807,"journal":{"name":"Journal of Nanjing Medical University","volume":"29 1","pages":"335-339"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86822332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of co-stimulatory molecules B7-2 and PD-L1 on peripheral blood mononuclear cells in patients with chronic hepatitis B virus infection","authors":"Lingxia Fei,&nbsp;Shipin Wu,&nbsp;Hongtao Chen","doi":"10.1016/S1007-4376(09)60082-4","DOIUrl":"10.1016/S1007-4376(09)60082-4","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the roles of the expression of the co-stimulatory molecule, B7-2, and the co-inhibitory molecule, PD-L1, on peripheral blood mononuclear cells in the mechanism of immunotolerance in chronic hepatitis B virus infection.</p></div><div><h3>Methods</h3><p>Thirty HBV infected patients in the immunoreactive phase and 20 patients in the immunotolerant phase were enrolled in the study, while 20 healthy volunteers were used as controls. RT- PCR and real-time PCR methods were used to detect the expression levels of B7-2 and PD-L1 mRNA in peripheral blood mononuclear cells in chronic HBV infected patients.</p></div><div><h3>Results</h3><p>The B7-2 expression in immunoreactive and immunotolerant patients was significantly lower than that in the controls (<em>P</em> all &lt; 0.01); B7-2 expression in immunoreactive patients was significantly lower than in immunotolerant patients (<em>P</em> &lt; 0.01). PD-L1 expression in immunoreactive patients and immunotolerant patients was significantly higher than that in normal controls (<em>P</em> all &lt; 0.01). The PD-L1/B7-2 ratios in immunoreactive and immunotolerant patients were significantly higher than that of the healthy controls (<em>P</em> all &lt; 0.01); the PD-L1/B7-2 ratio was significantly higher in the immunoreactive patients than in the immunotolerant patients (<em>P</em> &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>In chronic HBV infection, changes in the expression of co-stimulatory and co-inhibitory molecules imply a protective adjustment against the patient's immune response that may result in increased immunotolerance and persistent HBV infection.</p></div>","PeriodicalId":100807,"journal":{"name":"Journal of Nanjing Medical University","volume":"23 5","pages":"Pages 347-351"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1007-4376(09)60082-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75140079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentially expressed gene in osteosarcoma cell lines with different metastatic potentials","authors":"Xinzhi Li ,&nbsp;Lin Meng ,&nbsp;Anming Chen ,&nbsp;Fengjin Guo ,&nbsp;Zhenqiang Luo ,&nbsp;Heng Zeng","doi":"10.1016/S1007-4376(09)60083-6","DOIUrl":"10.1016/S1007-4376(09)60083-6","url":null,"abstract":"<div><h3>Objective</h3><p>To study the expression of osteosarcoma metastasis associated gene using a cDNA microarray, and screen new candidate genes related to the development, progress and osteosarcoma metastasis.</p></div><div><h3>Methods</h3><p>Total RNA of a low metastatic osteosarcoma and a high metastatic osteosarcoma (M6 and M8 cell lines, respectively) was extracted, purified to mRNA and then reverse transcribed to cDNA. M6 was used as the experimental group and M8 as the control group, and the gene expression of cells from both of these two sublines was investigated using cDNA microarrays containig 8064 cDNA clones. The cDNA of M6 was labeled with cy3 and the cDNA of M8 was labeled with cy5. The two sublines were hybridized with the cDNA microarray. The hybridization signals were scanned with a Generation III array scanner and analyzed by Imagequant 5.0 software.</p></div><div><h3>Results</h3><p>There were 330 differentially expressed genes between M6 and M8. In the M6 subline,152 genes were up-regulated and 178 genes were down-regulated compared to the M8 subline. These genes could be classified according to their function. Cell growth-related genes that were down-regulated included CCNG1, CDC2, APC10, and RPA3, while expression of the tumor suppressor genes, CDKN1A and CDKN2D, was up-regulated. Other genes that were differentially expressed included those that have been implicated in the regulation of signal transduction, metabolism and apoptosis.</p></div><div><h3>Conclusion</h3><p>This study exploits a cDNA microarray approach to identifying genes that may be associated with metastasis. The gene expression profiles of osteosarcoma cell lines is a potentially important index in the search of new candidate genes related to tumor occurrence, development and metastasis.</p></div>","PeriodicalId":100807,"journal":{"name":"Journal of Nanjing Medical University","volume":"23 5","pages":"Pages 352-358"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1007-4376(09)60083-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82398533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy and tolerability of lamotrigine adjunctive/monotherapy in patients with partial seizures refractory to poly-AEDs","authors":"Chunjie Song ,&nbsp;Huiling Chen ,&nbsp;Xiaoyong Wang ,&nbsp;Hui Wang ,&nbsp;Qi Wan","doi":"10.1016/S1007-4376(09)60078-2","DOIUrl":"10.1016/S1007-4376(09)60078-2","url":null,"abstract":"<div><h3>Objective</h3><p>This study was designed as an open-label trial to assess the effects of changing the antiepileptic drugs (AEDs) regi- men to lamotrigine (LTG) as adjunctive/monotherapy in patients with partial seizures who were dissatisfied with their drug regimen because of intractable seizures.</p></div><div><h3>Methods</h3><p>The patients were recruited from multicenters using the following criteria: age⩾18 years; at least 3 seizures per month during the last 16 weeks; previous use of at least 3 AEDs. The study involved a baseline phase and 2 experimental phases: LTG was first added to the regimen, and then patients could gradually change to LTG monotherapy if their seizures were reduced by at least 50 percent/month. Tolerability, the primary end point, was assessed using the Liverpool Adverse Experience Profile (LAEP). Secondary end points included quality of life, as measured with the Quality of Life in Epilepsy-31 inventory. Reductions in seizures from baseline throughout each phase were also analyzed.</p></div><div><h3>Results</h3><p>One hundred and fourteen patients aged between 18 and 52 years (age 27.8±13.2 years; 71 men and 43 women) were enrolled. After adding LTG, 105 patients (92.11%) completed adjunctive therapy. Upon completion of the adjunctive phase, mean improvement from baseline was 2.6 points on the LAEP (<em>p</em>=0.037). The overall score on the QOLIE-31 improved by 8.49 points from baseline (<em>p</em>=0.023). At the end of the trial, 26 (22.81%) of patients completed LTG monotherapy, and 65 patients (57.02%) experienced at least 50% reduction in seizure frequency compared to baseline, The mean improvement from baseline was 5.1 points on the LAEP (<em>p</em>=0.0059), and the overall score on the QOLIE-31 score improved by 12.72 points from baseline(<em>p</em>=0.0071). Twenty-two (19.30%) patients reported adverse effects and 9 patients discontinued participation in the trial because of adverse effects.</p></div><div><h3>Conclusion</h3><p>For patients with partial seizures who were dissatisfied with their AED regimen because of intractable seizures, adding LTG to the drug regimen was well tolerated and effective in improving the quality of life and controlling seizures. Furthermore, switching to LTG monotherapy was associated with further improvement.</p></div>","PeriodicalId":100807,"journal":{"name":"Journal of Nanjing Medical University","volume":"23 5","pages":"Pages 322-327"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1007-4376(09)60078-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76322247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the immunochromatographic strip test for the rapid diagnosis of antenatal syphilis in women in Eldoret, Kenya","authors":"Lydia B. Nyamwamu ,&nbsp;Michael M. Gicheru ,&nbsp;Rekha R. Sharma ,&nbsp;Albert Kimutai ,&nbsp;Willy K. Tonui ,&nbsp;Peter Kamau Ngure","doi":"10.1016/S1007-4376(09)60077-0","DOIUrl":"10.1016/S1007-4376(09)60077-0","url":null,"abstract":"<div><h3>Objective</h3><p>This study compared the performance of the immunochromatographic strip (ICS) to the Venereal Disease Research Laboratory (VDRL) test and Treponema pallidum haemagglutination assay (TPHA) at a primary health care setting.</p></div><div><h3>Methods</h3><p>The study group was comprised of 150 females randomly drawn from a population of pregnant women attending their first antenatal visit or follow-up visits at West Maternity Hospital in Eldoret Kenya, but without a previous syphilis test during that pregnancy. On-site VDRL, ICS and TPHA tests were performed and immediate treatment provided where appropriate. The performance of the three tests was compared.</p></div><div><h3>Results</h3><p>The sero-prevalence of syphilis as determined by the VDRL test was 3%. There was no significant difference between the ICS and the VDRL test (<em>P</em> &gt; 0.05). The sensitivity and specificity of the ICS test were 80% and 98.6% respectively, while the negative predictive value (NPV) and positive predictive value (PPV) were both 100%. On the other hand, the sensitivity and specificity of the VDRL test were 66.7% and 99.3%, while the NPV and PPV were 80% and 98.6% respectively. The Treponema pallidum haemagglutination assay was used as a reference test and had sensitivity, specificity, NPV and PPV of 100%.</p></div><div><h3>Conclusion</h3><p>The diagnostic accuracy of the ICS compared favorably with the VDRL gold standard. The use of the ICS in Kenya can improve the diagnosis of syphilis in health facilities both with and without laboratories and allow community health care workers to make a rapid diagnosis of the disease, and consequently make immediate therapeutic decisions.</p></div>","PeriodicalId":100807,"journal":{"name":"Journal of Nanjing Medical University","volume":"23 5","pages":"Pages 317-321"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1007-4376(09)60077-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75958444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective study: intraoperative 125I radioactive seed implant therapy in advanced esophageal squamous cell carcinoma","authors":"Jin Lü,&nbsp;Xiufeng Cao,&nbsp;Bin Zhu,&nbsp;Lü Ji","doi":"10.1016/S1007-4376(09)60080-0","DOIUrl":"10.1016/S1007-4376(09)60080-0","url":null,"abstract":"<div><h3>Objective</h3><p>To investigated the role of intraoperative iodine-125 (¹²⁵I) brachytherapy as a treatment option for advanced thoracic esophageal squamous cell carcinoma (ESCC).</p></div><div><h3>Methods</h3><p>Using preoperative computed tomography (CT)-based staging criteria, between 2000 and 2008, 298 patients with ESCC (stage II-III) were enrolled in this prospective study. With informed consent, patients were randomized into two groups: intraoperative ¹²⁵I seed implantation and surgery alone (control group). Twenty to forty ¹²⁵I seeds (0.5 mCi per seed), with a total activity in 10∼30 mCi, and a matched peripheral dose (MPD) of 60∼70 Gy, were implanted under direct visualization. The surgical procedure used in this study was either a radical resection, which involved an esophagectomy through a left thoracotomy with two-field lymphadenectomy, or palliative resection. The postoperative complications were observed and recorded. The location and quality assessment of ¹²⁵I seeds were assessed using CT scans or X-ray imaging. The short-term efficacy was evaluated according to WHO criteria. The 1, 3, 5 and 7-year survival rates were determined on follow-up.</p></div><div><h3>Results</h3><p>There was no displacement or loss of ¹²⁵I seeds. The local recurrence rates in the intraoperative ¹²⁵I seed implantation group and control group were 14.9% and 38.7%, respectively (<em>P</em> &lt; 0.05). An objective response rate of 92% was observed in the seed implant group, which was significantly higher than 0% in the control group (<em>P</em> &lt; 0.05). There was no significant difference between the two groups when comparing of complications (<em>P</em> &gt; 0.05). The 1-year survival rate of the two groups were not significantly different (<em>P</em> &gt; 0.05). However, the 3, 5 and 7-year survival rates in the united ¹²⁵I group (64%, 55.3% and 8%, respectively) were statistically different from those in the control group (52%, 29.1% and 1.4%, respectively)(<em>P</em> &lt; 0.05).</p></div><div><h3>Conclusion</h3><p>Intraoperative ¹²⁵I seed implantation is safe and effective for advanced ESCC. Seed implantation may reduce the local recurrence rate and improve survival in patients with ESCC. The MPD of 60∼70 Gy, with single ¹²⁵I seed activity of 0.5 mCi, is reasonable.</p></div>","PeriodicalId":100807,"journal":{"name":"Journal of Nanjing Medical University","volume":"23 5","pages":"Pages 335-339"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1007-4376(09)60080-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"119462011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of GSTM1 and GSTT1 genetic variant and markers of oxidative stress and inflammation in smokers with coronary artery disease","authors":"Changgao Zhou ,&nbsp;Jianjin Tang ,&nbsp;Mingwei Wang ,&nbsp;Jianjun Yan ,&nbsp;Qiming Wang ,&nbsp;Jun Zhu ,&nbsp;Zhijian Yang ,&nbsp;Liansheng Wang","doi":"10.1016/S1007-4376(09)60074-5","DOIUrl":"10.1016/S1007-4376(09)60074-5","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the role of glutathione S-transferase (GST) genetic variants and markers of oxidative stress and inflammation in smoking- related coronary artery disease (CAD) patients.</p></div><div><h3>Methods</h3><p>Five hundred and thirty-five Chinese CAD patients were successfully genotyped. Plasma total antioxidant status (TAOS), glutathione, C-reactive protein (CRP), fibrinogen(FIB) and white blood cell count (WBC) were determined to evaluate the oxidative stress and inflammatory response.</p></div><div><h3>Results</h3><p>GSTM1-0/GSTT1-0 subjects had a higher CRP, FIB, WBC and GSH and a lower TAOS compared to patients with wild-type GSTM1/GSTT1 genes, but there was significant difference only with regards to TAOS. Smokers with the null genotype of GSTT1 had the highest CRP and the lowest TAOS and GSH when compared to the GSTT1-1 genotype with smoking status, or the GSTT1-0 genotype with non-smoking status, or the GSTT1-1 genotype with non-smoking status. However, we found no significant difference between these groups. Also, no significant interaction was observed between genotypes and smoking status in determining CRP levels.</p></div><div><h3>Conclusion</h3><p>Our results suggest that GST polymorphisms do not modify the effect of smoking on markers of oxidative stress and inflammation in Chinese CAD patients.</p></div>","PeriodicalId":100807,"journal":{"name":"Journal of Nanjing Medical University","volume":"23 5","pages":"Pages 300-304"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1007-4376(09)60074-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81490603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manganese superoxide dismutase polymorphism and prostate cancer risk: a meta-analysis","authors":"Bingbing Wei ,&nbsp;Yunyun Zhang ,&nbsp;Bo Xi ,&nbsp;Jiantang Su","doi":"10.1016/S1007-4376(09)60081-2","DOIUrl":"10.1016/S1007-4376(09)60081-2","url":null,"abstract":"<div><h3>Objective</h3><p>MnSOD plays a vital role in carcinogenesis, partly in that it converts superoxide radical to oxygen and hydrogen peroxide. The conflicting results of studies on the role of MnSOD polymorphism (Val−9Ala) with the risk of prostate cancer encouraged us to perform a meta-analysis to examine the association.</p></div><div><h3>Methods</h3><p>A comprehensive search was conducted to examine all the eligible studies of MnSOD polymorphism and prostate cancer risk. We used odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association. The pooled estimates of ORs were computed using the fixed-effects model or random- effects model.</p></div><div><h3>Results</h3><p>Ten eligible studies, including 4 608 cases and 5 861 controls, were included in this meta-analysis. Overall, individuals with Ala/Ala and Ala/Val genotypes have an increased risk of prostate cancer, compared with those carrying the Val/Val genotype (Ala/Ala vs. Val/Val: OR=1.13; 95% CI=1.02∼1.25; <em>P</em> = 0.020, P_{heterogeneity}=0.370; Ala/Val vs. Val/Val: OR=1.14; 95% CI=1.04∼1.25; <em>P</em> = 0.004, P_{heterogeneity}=0.940). This significant association was also found in a dominant model with −9Ala allele (Ala/Ala+Ala/Val vs. Val/Val: OR=1.12; 95% CI: 1.03∼1.22; <em>P</em> = 0.009, P_{heterogeneity}=0.64). In the subgroup by ethnicity, it was observed that significantly elevated prostate cancer risk was associated with −9Ala allele in Caucasians (Ala/Ala vs. Val/Val: OR=1.14; 95% CI=1.03∼1.27; <em>P</em> = 0.01, P_{heterogeneity}=0.31; Ala/Val vs. Val/Val: OR=1.14; 95% CI=1.04∼1.24; <em>P</em> = 0.006, P_{heterogeneity}=0.87) but not in African-Americans. Furthermore, this meta-analysis showed that the −9Ala allele was associated with both nonaggressive and aggressive prostate cancer risks.</p></div><div><h3>Conclusion</h3><p>Our meta-analysis suggests that MnSOD Val−9Ala polymorphism is associated with prostate cancer risk, especially in Caucasians.</p></div>","PeriodicalId":100807,"journal":{"name":"Journal of Nanjing Medical University","volume":"23 5","pages":"Pages 340-346"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1007-4376(09)60081-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78851354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduction in pulmonary complications in high risk patients undergoing surgery for total hip replacement under general anesthesia by preoperative intensive inspiratory muscle training : A randomized controlled clinical trial","authors":"Bingqiang Ma,&nbsp;Hongguang Bao","doi":"10.1016/S1007-4376(09)60079-4","DOIUrl":"10.1016/S1007-4376(09)60079-4","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the effects of preoperative inspiratory muscle training (IMT) on the incidence of atelectasis in patients at high risk of postoperative pulmonary complications scheduled for elective total hip replacement surgery under general anesthesia.</p></div><div><h3>Methods</h3><p>Thirty two high-risk patients undergoing elective total hip replacement surgery under general anesthesia were chosen from Nanjing Medical University, Affiliated Nanjing First Hospital. In this single-blind randomized controlled clinical trial, patients were randomly assigned to receive preoperative inspiratory muscle training or conventional treatment (CT). The major effectiveness outcome variables were atelectasis and duration of postoperative hospitalization.</p></div><div><h3>Results</h3><p>Both groups were comparable prior to surgery. Seven patients in the CT group and 3 in the IMT group developed atelectasis (<em>P</em> = 0.25). Median duration of postoperative hospitalization was 13 days (range, 10∼17 days) in the IMT group versus 16 days (range, 11∼23 days) in the CT group (Mann- Whitney U statistics, Z = −2.22, <em>P</em> = 0.03). Mean postoperative inspiratory pressure was 5% higher in the IMT group.</p></div><div><h3>Conclusion</h3><p>Preoperative intensive inspiratory muscle training appears to reduce the incidence of atelectasis and duration of postoperative hospitalization in patients at high risk of developing postoperative pulmonary complications who were scheduled for elective total hip replacement surgery under general anesthesia.</p></div>","PeriodicalId":100807,"journal":{"name":"Journal of Nanjing Medical University","volume":"23 5","pages":"Pages 328-334"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1007-4376(09)60079-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86589433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and surgical treatment of intraveneous leiomyomatosis extending into the heart: two cases report and review of the literature","authors":"Xiaowei Wang,&nbsp;Lin Zhang,&nbsp;Yijiang Chen,&nbsp;Shijiang Zhang,&nbsp;Jianwei Qin,&nbsp;Yanhu Wu,&nbsp;Jinhua Luo","doi":"10.1016/S1007-4376(09)60075-7","DOIUrl":"10.1016/S1007-4376(09)60075-7","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the clinical characteristics, diagnosis and surgical treatment of intravenous leiomyomatosis (IVL), and outline the differences between Chinese and overseas cases.</p></div><div><h3>Methods</h3><p>Clinical data of two IVL cases, treated in our hospital, were analyzed retrospectively and the related literature was also reviewed. The data of preoperative diagnostic rate, surgical procedures, and postoperative recurrence between patients in China and other countries were compared.</p></div><div><h3>Results</h3><p>The first stage operation was performed successfully in 2 patients. However, they refused subsequent therapies, including a second stage operation to excise the remnants of the tumor, uterus, bilateral oviducts and ovaries, and anti-estrogen therapy. Both suffered from IVL recurrence, one at 6-month and the other at 9-month, and died at 16-month and 12-month respectively after the first stage surgery. Worldwide reports of 110 IVL cases were reviewed, which included 28 cases in China and 82 cases in other countries. In the majority of the Chinese patients, tumors only extended into the right atrium rather than the right ventricle (RA 22 cases vs RV 4 cases). However, among the overseas patients, the rate of extension into the right atrium was similar to that of extension into the right ventricle (RA 41 cases vs RV 38 cases). The rate of hysterectomies was not significantly different between Chinese and overseas patients (67.86% vs 55.9%, <em>P</em>=0.278). The rate of correct preoperative diagnosis in the Chinese patients was significantly lower than that in the overseas patients (32.14% vs 80%, <em>P</em>=0.000002), as well as the rate of complete excision of the tumor (22.7% vs 75.5%, <em>P</em>=0.000001). The proportion of patients who undergoing a single-stage or a two-stage operation was similar in Chinese and overseas patients. The recurrence rate was significantly higher in the Chinese patients than in the overseas patients (36.8% vs 9.1%, <em>P</em>=0.0055), and the patients with tumor recurrence were partial tumor excision patients.</p></div><div><h3>Conclusion</h3><p>The possibility of IVL should be considered if echocardiography in female patients demonstrates a tumor in the right heart and a mass in the inferior vena cava (IVC). Further imaging should be performed to confirm the diagnosis. The correct diagnosis and accurate preoperative delineation of tumor extension are essential for an optimal surgical outcome. The key point in IVL treatment is the complete excision of tumors (single-stage or two-stage surgical procedure).</p></div>","PeriodicalId":100807,"journal":{"name":"Journal of Nanjing Medical University","volume":"23 5","pages":"Pages 305-310"},"PeriodicalIF":0.0,"publicationDate":"2009-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1007-4376(09)60075-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75019912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}