Laparoscopic removal of a rudimentary uterine horn during pregnancy. A case report.

BACKGROUND: A unicornuate uterus with a rudimentary horn is a müllerian anomaly associated with endometriosis and pregnancy complications, including miscarriage, ectopic pregnancy, uterine rupture, preterm labor and malpresentation. Therefore, the horn is removed if it is thought to contain functional endometrium. This is usually done by laparotomy in the nonpregnant state. CASE: A woman presented during pregnancy with symptoms, examination and ultrasonogram suspicious for an ectopic pregnancy. Intraoperative findings and final pathology, however, showed a rudimentary uterine horn, which was laparoscopically removed, and a concomitant intrauterine pregnancy. CONCLUSION: A rudimentary uterine horn may present during pregnancy and mimic an ectopic pregnancy. In this case, the horn was removed laparoscopically.

Abdominoplasty following vertical banded gastroplasty for morbid obesity.

We describe 15 patients who underwent abdominoplasty following vertical banded gastroplasty for morbid obesity between 1991 and 1994. Vertical banded gastroplasty was performed (by CMSR) on patients with a Body Mass Index greater than 39. Following this, the patients lost weight rapidly, leading to excess folds of skin and fat on the abdomen, arms and thighs, and were referred for plastic surgery when their weight had stabilised. After abdominoplasty, the Body Mass Indices of all the patients decreased to an acceptable range. Because vertical banded gastroplasty causes little long-term metabolic or nutritional disturbance, the abdominal skin could be undermined up to the costal margin and the umbilicus re-sited without major necrosis of the abdominal wall or umbilicus. All patients received prophylactic low dose heparin perioperatively until early ambulation. Prophylactic antibiotics were not used but there were no major wound infections. Patients were reviewed up to 12 months after abdominoplasty and were satisfied with the results. Abdominoplasty following vertical banded gastroplasty for morbid obesity safely provides acceptable cosmetic results.

Identification and characterization of CCK-B/gastrin receptors in human pancreatic cancer cell lines.

The gastrointestinal peptide cholecystokinin (CCK) is known to stimulate growth of human pancreatic cancer in a receptor-mediated fashion. The purpose of this study was to characterize the receptor responsible for the trophic effects of CCK in cancer cells. With the use of homogenates of PANC-1 human pancreatic cancer cells grown in vitro, the binding characteristics and optimal conditions of radiolabeled selective CCK-receptor antagonists ([3H]L-365,260 and [3H]L-364,718) were examined. Specific and saturable binding was detected with [3H]L-365,260, and Scatchard analysis revealed that the data were consistent for a single site of binding with a binding affinity of 4.3 +/- 0.6 nM and a binding capacity (Bmax) of 283 +/- 68 fmol/mg protein in log phase cells. Binding was dependent on protein concentration, time, temperature, and pH and was sensitive to Na+, K+, Mg2+, and ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid. In contrast to log phase cells, Bmax decreased by 80 and 92% in confluent and postconfluent cultures, respectively. Subcellular fractionation studies revealed that binding was in the membrane fraction. Competition experiments indicated that L-365,260 and gastrin were more effective at displacing the radiolabeled L-365,260 than CCK. No binding was detected with the CCK-A antagonist [3H]L-364,718. Assays performed with [3H]L-365,260 on five additional human pancreatic cancer cell lines in vitro and tumor tissue from xenografts in nude mice also revealed specific and saturable binding. These results provide the first identification of a CCK-B/gastrin receptor in human pancreatic cancer cells and tumors and explain the effects of CCK on the growth of this malignancy.