Clinical features and overall survival of osteosarcoma of the mandible.

Osteosarcoma is the most common bone sarcoma and is typically found in the distal femur, proximal tibia, and proximal humerus. While several factors are known to influence survival, less is known regarding the influence of primary tumor location. This study describes the clinical features and prognosis of mandibular osteosarcoma. The SEER database was utilized to identify cases of mandibular osteosarcoma diagnosed between 2004 and 2015. Sex, age, grade, histological subtype, tumor size, tumor extension, presence of metastasis at diagnosis, and therapeutic intervention were determined. Osteosarcomas originating from other sites were assessed for comparison. There were 164 cases of mandibular osteosarcoma identified, representing 5.5% of all surveyed osteosarcomas. The 2-, 5-, and 10-year overall survival rates were 79.9%, 65.6% and 58.5%, respectively. Survival was worse for patients with older age, larger tumor size, metastatic disease, and absence of surgical resection. Compared to other sites, mandibular osteosarcomas were significantly smaller tumors and were far less likely to metastasize. Mandibular osteosarcoma manifested at an older age than the more common extremity osteosarcomas and presented with smaller tumors. Rates of metastasis of jaw osteosarcoma were much lower than osteosarcoma found in the extremities, while mortality rates were comparable.

SUMO co-expression modifies KV 11.1 channel activity.

AIM: The voltage-gated potassium channel KV 11.1 is the molecular basis for the IKr current, which plays an important role in cardiac physiology. Its malfunction is associated with both inherited and acquired cardiac arrhythmias. Native currents differ from those in experimental models, suggesting additional regulatory mechanisms. We hypothesized that the post-translational modification sumoylation fine-tunes channel activity. METHODS: The functional effects of sumoylation on KV 11.1 were addressed by employing two-electrode voltage-clamp (TEVC) experiments in Xenopus laevis oocytes. Site-directed mutagenesis enabled a further analysis of the SUMO-target amino acids. We assessed protein expression levels and used confocal imaging for localization studies. RESULTS: Co-expression with Ubc9 and SUMO alters the electrophysiological properties of KV 11.1 leading to a decrease in steady-state current amplitude largely due to faster inactivation and alteration of deactivation kinetics. We identified three lysines (K21, K93 and K116) in the PAS domain as the putative SUMO-targets. CONCLUSION: This study indicates KV 11.1 as a sumoylation target and offers three main targets: K21, K93, and K116. Furthermore, it proposes an underlying mechanism for the observed kinetic impact of the PAS domain.

Fluid absorption and the long-term outcome after transcervical resection of the endometrium.

BACKGROUND: Fluid absorption may cause symptoms of acute volume overload and has also been associated with a less favorable outcome after endometrial resection. To further study this topic, we evaluated the incidence of fluid absorption, the factors associated with absorption, and the relationship between fluid absorption and the long-term outcome after TCRE. METHOD: Two hunded and sixty-five women underwent TCRE in which the absorption of irrigating fluid (glycine 1.5%) was measured volumetrically. Physical examinations were made and questions about menstrual blood loss and cyclic pelvic pain were asked before the operation and 12 weeks and 1, 2, and 3 years later. RESULTS: Fluid absorption was increased in patients treated with a GnRH analogue (leuprolide acetate) prior to the TCRE (p<0.007) and also when a submucous myoma was removed during the operation (p<0.0001). About 40% of the women operated on still had menstrual bleeds 1 year later, and this correlated with a larger fluid absorption (p<0.04). Dysmenorrhea disappeared in half the patients, while 17% of those who were pain-free before the TCRE had developed cyclic pelvic pain at 1 year, an outcome also associated with a larger fluid absorption (p<0.02). Pain correlated with lower patient satisfaction, preserved menstrual bleeds, and with the presence of remnants of endometrial tissue as imaged by transvaginal ultrasonography. CONCLUSIONS: Resection of a submucous adenoma increases the risk of fluid absorption during TCRE. The results also indicate that fluid absorption is associated with persistent menstrual bleeding and late development of cyclic pelvic pain.

Endometrial resection and late reoperation in the treatment of menorrhagia.

STUDY OBJECTIVE: To evaluate the effectiveness of transcervical resection of the endometrium and indications for late reoperation. DESIGN: Retrospective study. SETTING: Central hospital in northern Norway. PATIENTS: Two hundred fifty women (age 30-59 yrs) with dysfunctional bleeding. INTERVENTIONS: Hysteroscopic transcervical resection of the endometrium. MEASUREMENTS AND MAIN RESULTS: Success as measured by patient satisfaction at 3-month follow-up was 97% and at 4 to 48 months was 91.6%. Mean observation time was 24 months. Twenty-one women required further surgery. Repeat resection was performed in eight women (3.2%), of whom 95% were satisfied. Thirteen women (5.2%) had a hysterectomy. Late reoperation was performed in 7 patients (2.8%) due to recurrent unacceptable vaginal bleeding and in 14 (5.6%) due to late onset of pain. CONCLUSION: After endometrial resection, a definite subgroup (8.4%) of women developed late onset of pain or bleeding requiring reoperation.

[Continuous flow hysteroscopy. An improved endoscopic method for examination of the uterine cavity]. / Hysteroskopi med kontinuerlig vaeskegjennomskylling. En forbedret endoskopisk metode til undersøkelse av uterinkaviteten.

A new technique for hysteroscopic visualisation of the uterine cavity has significantly increased the accuracy of diagnosing intrauterine disorders. Major breakthroughs in this field have been the introduction of the use of continuous flow hysteroscopy. We describe the recent development of the new generation continuous flow hysteroscope and our experience of the first 91 continuous flow hysteroscopies in paracervical block at our outpatient clinic. The problems of mucus, blood and debris, which earlier could disturbingly blur the vision when using CO2 as distension medium, have now been overcome with the new generation continuous flow hysteroscope. During the period from 1 February to 31 July 1994 we performed in paracervical block 91 continuous flow hysteroscopies at our outpatient clinic. We experienced no failure in the examinations, and had no complications. We found normal uterine cavity in 53% of the patients, macroscopic pathology in 44% and in 3% of the patients a missed intrauterine device was located in the uterine cavity.