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1.
Article in English | WPRIM | ID: wpr-1045519

ABSTRACT

BACKGROUND@#Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a severe congenital disorder characterized by vaginal hypoplasia caused by dysplasia of the Müllerian duct. Patients with MRKH syndrome often require nonsurgical or surgical treatment to achieve satisfactory vaginal length and sexual outcomes. The extracellular matrix has been successfully used for vaginal reconstruction. @*METHODS@#In this study, we developed a new biological material derived from porcine vagina (acellular vaginal matrix, AVM) to reconstruct the vagina in Bama miniature pigs. The histological characteristics and efficacy of acellularization of AVM were evaluated, and AVM was subsequently transplanted into Bama miniature pigs to reconstruct the vaginas. @*RESULTS@#Macroscopic analysis showed that the neovaginas functioned well in all Bama miniature pigs with AVM implants. Histological analysis and electrophysiological evidence indicated that morphological and functional recovery was restored in normal vaginal tissues. Scanning electron microscopy showed that the neovaginas had mucosal folds characteristics of normal vagina. No significant differences were observed in the expression of CK14, HSP47, and a-actin between the neovaginas and normal vaginal tissues. However, the expression of estrogen receptor (ER) was significantly lower in the neovaginas than in normal vaginal tissues. In addition, AVM promoted the expression of b-catenin, c-Myc, and cyclin D1. These results suggest that AVM might promotes vaginal regeneration by activating the b-catenin/cMyc/cyclin D1 pathway. @*CONCLUSION@#This study reveals that porcine-derived AVM has potential application for vaginal regeneration.

2.
Chinese Journal of Surgery ; (12): 441-445, 2017.
Article in Chinese | WPRIM | ID: wpr-808809

ABSTRACT

Objective@#To investigate the surgical outcomes and prognosis of spinal cord anaplastic astrocytoma (AA).@*Methods@#A total of 27 consecutive patients diagnosed as spinal cord AA between January 2008 and May 2015 in Department of Neurosurgery of Beijing Tiantan Hospital were retrospectively reviewed. There were 18 males and 9 females, the mean age was (30.7±13.0) years (ranging from 5 to 52 years). The lesions were located at cervical level in 8 patients, at thoracic level in 9 patients, at cervicothoracic level in 3 patients, and at thoracolumbar level in 7 patients, the average number of vertebral was 3.3±1.3.The median time from onset of symptom to surgery was 4 months, ranging from 3 days to 48 months. The clinical presentations were weakness (23 cases), paresthesia (22 cases), pain (20 cases), sphincter disorder (15 cases) and paralysis (7 cases). The preoperative modified McCormick scale was as follows: grade Ⅱ for 6 cases, grade Ⅲ for 7 cases, grade Ⅳ for 7 cases, grade Ⅴ for 7 cases. The tumors were surgically removed via posterior median approach with the monitoring of the somatosensory-evoked potentials to minimize the neurological injury. All of the patients were recommonded to receive adjuvant chemotherapy and radiotherapy postoperatively after pothological verified and followed up by clinic interview or telephone postoperatively. Log-rank test was used to calculate the survival rate.@*Results@#Gross total resection and subtotal resection were achieved in 18 patients and partial resection in 9. Twenty patients received adjuvant chemotherapy and (or) radiotherapy, 7 patients did not received chemoradiation postoperatively. Nineteen patients died and 8 were alive at the last follow-up. The median survival time was 23 months with 1 and 2-year survival rates of 85.2% and 50.0%.There was no statistical significance between subtotal resection group and partial resection group(χ2=0.089, P=0.880), the survival rates of patients in chemotherapy group and radiotherapy group were increased significantly(χ2=6.687, P=0.001; χ2=14.887, P=0.002).@*Conclusions@#Spinal cord AA is a rare spinal high-grade astrocytoma with aggressive nature, the prognosis remains poor even after comprehensive treatments. Microsurgery followed by adjuvant chemoradiation is recommended for the treatment.

3.
Chinese Journal of Surgery ; (12): 953-956, 2015.
Article in Chinese | WPRIM | ID: wpr-349234

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinical features, diagnostic and therapeutic strategy of primary intraspinal melanocytoma.</p><p><b>METHOD</b>The clinical data of primary intraspinal melanocytoma patients who underwent surgical operations from June 2011 to December 2014 in Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University were retrospectively reviewed.</p><p><b>RESULTS</b>Six cases of intraspinal melanocytoma, identified with pathology were collected, including 5 male and 1 female patients with the average age of 39.8 years (range 23-50 years). Limbs anesthesia and weakness were present in 2 cases. Neck and back pain were present in 4 cases. All patients performed MRI examination before operation, and only 1 case was diagnosed as primary melanocytoma, and the others were confirmed by postoperative pathology. All cases were confirmed by the pathological examination. Total resection was achieved in 2 cases, subtotal resection was achieved in 2 cases, 2 disseminated cases only achieved partial resection. The average period of postoperative follow-up process was 25.7 months(range 9-52 months). One case recurred in 9 months after surgery and died in 16 months, one case recurred in 1 year after surgery, and the other 4 cases had no recurrence. The recurrenced 2 patients had been not treated with radiotherapy, 2 patients of the 4 that not recurrenced had received radiotherapy. All patients didn't receive chemotherapy. The other patients were in good condition after surgery.</p><p><b>CONCLUSIONS</b>The intraspinal primary melanocytoma is less likely to recurrence and metastasis if total resection is achieved. Diagnosis relies on pathology. Surgery is the first choice and early total resection is strongly recommend. Appropriate radiotherapy for partial resection cases can delay tumor recurrence.</p>


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Magnetic Resonance Imaging , Melanoma , Retrospective Studies , Spinal Neoplasms
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