Original correct diagnosis affects the prognosis of patients with uterine sarcomas / 解放军医学杂志

Objective To analyze the causes of misdiagnosis of uterine sarcomas and to explore the measures to reduce these errors. Methods A retrospective study of 40 cases of uterine sarcomas admitted between January 1980 and June 2002 to our hospital was performed. Results Uterine sarcomas were easily misdiagnosed as leiomyomas. A correct diagnosis of uterine sarcoma was made at primary operation in 15 cases (37.5%). A wrong diagnosis was made in 25 cases (62.5%), and among them re-operation was done in 15 cases. In 7 patients, three operations were performed. Recurrence rate was as high as 64.0%. The rate of hematogenous dissemination was also high. The patients in whom a misdiagnosis was made at their primary operation were younger in age than the patients in whom a correct diagnosis was made (43 years vs 50 years). The amounts of bleeding and transfusion during operations were increased in patients with misdiagnosis. Conclusions Atypical manifestations and lack of knowledge about the diseases were the main causes for misdiagnosis of uterine sarcomas. Misdiagnosis might be avoided by a comprehensive analysis of all clinical information. Radical resection of the primary tumor was the most significant means to ensure a better prognosis.

Pathogenic Analysis of Pelvic and Peritoneal Abscess and Its Clinical Management / 中华医院感染学杂志

OBJECTIVE To explore the pathogenesis of pelvic and peritoneal abscesses and their clinical(management).METHODS Clinical data of 109 patients with pelvic and peritoneal abscesses between 1999 and 2005 were retrospectively(evaluated).The connection of their pathogenesis,antibiotics choice,and treatment types with(prognoses) was analyzed.RESULTS Pus from all patients was collected and sent to do germ culture and antibiotic susceptibility testing.Seventy five cases were with positive germ culture.The most germs were Escherichia coli and meropenem and amikacin were considered effective.Four cases were relapsed after surgery from 90 cases.(Pelvic) abscess drainage was performed through vagina under B type ultrasound guiding in 9 cases.Conservative treatment was given in 10 cases and no patient died.CONCLUSIONS Pelvic and peritoneal abscesses should be treated early with antibiotic according susceptibility testing to make a choice.And surgery or sufficient abscess drainage can(improve) their prognosis.

EFFECT OF NODAL METASTASIS ON THE PROGNOSIS OF PATIENTS WITH ENDOMETRIAL CANCER / 解放军医学杂志

To study the nodal distribution in endometrial carcinoma and to evaluate its effect on recurrence and survival, 230 patients with endometrial carcinoma were reviewed and analyzed. 32(20 25%)cases were found to have lymph node metastasis. Stage Ⅲc disease was defined by positive PLN alone in 22 cases, positive PLN and PALN in 4 cases, and positive PALN alone in 6 cases. Positive peritoneal cytology and adnexal metastasis were present in 10 patients. Only 2/10 of these patients had isolated positive PLN whereas 8/10 had positive PALN ( P 0 05). These findings indicate that PALN involvement is common in patients with FIGO Stage Ⅲc endometrial cancer, and suggest that PLN sampling alone may result in underdiagnosis of disease, and dissection of PALN may have a significant therapeutic role.