ABSTRACT
Leiomyosarcoma of the vagina is quite rare. Extensive search of the literature discloses 137 case reports published over the past 40 years. Collectively, these reports give only cursory guidelines for diagnosis, management, and prognosis. We add another case to the sparse literature on leiomyosarcoma of the vagina. Treatment consisted of surgical excision. Tumor was found to extend to the margin of the excised specimen. The malignancy quickly recurred with lung metastases and the patient died. The very poor prognosis associated with this lesion emphasizes the critical need for early diagnosis and expeditious therapy. In the interest of improving salvage by prompt recognition and intervention, it is important for health-care professionals to be knowledgeable about and alert to this condition.
Subject(s)
Leiomyosarcoma/secondary , Lung Neoplasms/secondary , Vaginal Neoplasms/pathology , Adult , Fatal Outcome , Female , Humans , Leiomyosarcoma/surgery , Lung Neoplasms/surgery , Prognosis , Vaginal Neoplasms/surgeryABSTRACT
A survey was mailed to all 292 nonmilitary obstetrics and gynecology residency programs in the United States. The extent and type of ultrasound training and degree of compliance with recommended guidelines was evaluated from the 230 (78.8%) responses. Criteria for evaluation were based on guidelines from the American Institute of Ultrasound in Medicine Joint Task Group on Training for Diagnosis in Obstetrical and Gynecological Ultrasound, and on recommendations from The American College of Obstetricians and Gynecologists. Although almost 98% of respondents claimed to have ultrasound "training" in their programs, more than 55% indicated no resident experience with either reading or writing ultrasound reports, and only 39% of program chiefs claimed greater experience than 200 ultrasound scans per resident over four years. Overall, it appears that current suggested guidelines are not being met.
Subject(s)
Gynecology/education , Internship and Residency , Obstetrics/education , Ultrasonography , Data Collection , Female , Humans , United StatesSubject(s)
Cesarean Section/statistics & numerical data , Apgar Score , Female , Fetal Death , Humans , Infant, Newborn , Institutional Practice , PregnancyABSTRACT
Primary ovarian carcinoma and pregnancy are rarely found to coexist. We report here a case of cystadenocarcinoma discovered as an incidental finding during an elective cesarean section in a 26-year-old woman.
Subject(s)
Cesarean Section , Cystadenocarcinoma/pathology , Ovarian Neoplasms/pathology , Pregnancy Complications, Neoplastic/pathology , Adult , Cystadenocarcinoma/diagnosis , Cystadenocarcinoma/surgery , Female , Humans , Infant, Newborn , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/surgery , Pregnancy , Pregnancy Complications, Neoplastic/diagnosis , Pregnancy Complications, Neoplastic/surgerySubject(s)
Pregnancy Complications , Pregnancy, Multiple , Twins , Uterus/abnormalities , Adult , Female , Humans , Pregnancy , Prenatal Diagnosis , UltrasonographyABSTRACT
Thirty-nine patients received aortic valve replacement prostheses. The 19 patients who received Starr-Edwards (SE) caged-ball valve prostheses and the 20 patients who received Björk-Shiley (BS) tilting-disc valve prostheses were followed up for a mean period of 20 and 19 mo, respectively. The cumulative mortality rate was 5.3% in the SE group and 15% in the BS group. The clinical improvement was more remarkable in the BS than in the SE series. Major thromboembolic complications developed in three patients in each group, and two patients in each group developed infectious endocarditis. Tests for intravascular hemolysis indicated a higher rate in the SE than in the BS group. The serum haptoglobin levels were 39 +/- 22 and 102 +/- 63 g/dl (mean +/- SD), respectively (P less than 0.001). The hemoglobin level was 12.4 +/- 1.8 g/dl in the SE group and 13.4 +/- 0.6 g/dl in the BS group (P less than 0.03). The BS tilting-disc valve caused less hemolysis and the smaller size led to greater clinical improvement.
