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Lin B.-L.,Kawasaki Municipal Hospital | Iida M.,Kawasaki Municipal Hospital | Yabuno A.,Kawasaki Municipal Hospital | Higuchi T.,Kawasaki Municipal Hospital | And 3 more authors.
Gynecology and Minimally Invasive Therapy | Year: 2013

Objective: To evaluate the efficacy of a newly developed snare system used for hysteroscopic polypectomy in a small-caliber diagnostic flexible hysteroscope. Materials and methods: One hundred thirty-eight women (age 26-69 years) with endometrial polyps underwent hysteroscopic polypectomy using a Lin polyp snare system in a small-caliber diagnostic flexible hysteroscope without cervical dilation, analgesia, anesthesia, or use of a tenaculum. No electric current was used during the procedure. Results: Indications of hysteroscopic examinations for these 138 women were infertility in 56, abnormal uterine bleeding in 43, menorrhagia in 17, abnormal ultrasound findings in 20, and abnormal intrauterine pathologic or cytologic findings in 2. Sixty-nine women had a single polyp, whereas the other 69 had multiple polyps. In 11 women, the polyps were only excised without removing the specimens. In 29 women, the polyps were removed partly by a snare first and the remaining polyps by a polyp grasper. In 49 women, the polyps were transected by a snare and the specimens were removed by a polyp grasper. In the other 49 women, the polyps were transected and removed only by using a snare. Most of the women had a satisfactory specimen, but there were 28 women with small specimens and 11 women with no specimen. The pathologic findings were endometrial polyps in 100 women, endometrium in 17, endometrial hyperplasia complex in three, atypical endometrial hyperplasia complex in three, adenomyoma in two, atypical polypoid adenomyoma in one, and endometrial carcinoma in one. The painful sensation was slight and all patients could tolerate the whole procedures. No special complication other than bleeding for several days was encountered. Conclusions: Endometrial polyps can be removed using a Lin polyp snare system equipped in a small-caliber flexible hysteroscopy without requiring cervical dilation, anesthesia, analgesia, or a tenaculum in the office. This procedure may substitute for blind dilation and curettage for intrauterine pathologic evaluation. © 2013.

Lin B.-L.,Kawasaki Municipal Hospital | Higuchi T.,Kawasaki Municipal Hospital | Yabuno A.,Kawasaki Municipal Hospital | Kashinoura K.,Kawasaki Municipal Hospital | And 4 more authors.
Gynecology and Minimally Invasive Therapy | Year: 2012

Objective: To evaluate the efficacy of hysteroscopic myomectomy using the Lin dissecting loop and Lin myoma graspers to remove myoma in a single procedure. Materials and Methods: This was a retrospective study performed in the gynecologic department of a general hospital. A total of 1569 women with submucous myoma or symptomatic intramural myoma underwent one-step resectoscopic myomectomy using Lin dissecting loop and Lin myoma graspers. Results: Of the 1569 patients, pedunculated submucous myoma, sessile submucous myoma, and intramural myoma were diagnosed in 943, 608, and 19 patients, respectively. The patients' median age was 38.6 years (range 19-59 years). The operating time was between 4. minutes and 147. minutes (mean 30.6±18.2 minutes). The specimen weighed from 0.1. g to 380. g (mean 19.9±21.4 g). Two uterine perforations caused by myoma graspers were encountered. No fluid complications were experienced. Almost all of the patients had improvement of symptoms. Long-term follow-up revealed five cases of abdominal total hysterectomy, one case of abdominal myomectomy, 21 cases of rehysteroscopic operation, 59 cases of normal spontaneous delivery, 36 cases of cesarean section, five cases of ongoing pregnancy, and one case of spontaneous abortion. No case of uterine rupture was encountered. There was one case of placenta accreta that required hysterectomy. Conclusion: Using our technique and instruments, it is possible to remove a myoma in a single procedure safely and effectively. This surgical method can also preserve more endometrium, cause less injury to the muscle layer, and prevent fluid complications. © 2012.

Yao T.T.,Sun Yat Sen University | Mo S.M.,Kiang Wu Hospital | Liu L.Y.,Sun Yat Sen University | Lu H.W.,Sun Yat Sen University | And 2 more authors.
Genetics and Molecular Research | Year: 2013

The methylation of tumor suppressor genes has been shown to be involved in many human cancers. 5-Aza-2'-deoxycytidine (5-Aza-CdR) can reactivate the expression of methylated tumor suppressor genes. In our study, 2 human cervical cancer cell lines, HeLa and SiHa, were treated with different concentrations (20, 10, 5, and 2.5 μM) of 5-Aza-CdR for 24, 48, and 72 h. After incubation, cells were analyzed by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide assay and flow cytometry. The expression of RASSF1A and APAF-1 was detected by RT-PCR. 5-Aza-CdR inhibited the growth of HeLa and SiHa cells at different concentrations. The strongest inhibition and apoptosis rates were obtained after incubation for 72 h (5.63 ± 1.38 and 8.24 ± 2.40%, respectively). No significant difference in the expression of RASSF1A was found upon drug treatment, while APAF-1 expression increased in HeLa cells after treatment (0.790 ± 0.056%). Our results suggest that the tumor-suppressive effect of 5-Aza-CdR may result from the reactivation of silenced APAF-1 through demethylation. © FUNPEC-RP.

Guo H.,The First Affiliated Hospital | Nan K.,The First Affiliated Hospital | Hu T.,The First Affiliated Hospital | Meng J.,The First People Hospital | And 4 more authors.
Hepatology Research | Year: 2010

Aim: To investigate the unbalance of proliferation and apoptosis and the functions of cell-cycle proteins and apoptotic factor in metastasis of hepatocellular carcinoma (HCC) and their effect in prognosis.Methods: Proliferation index and apoptosis index, as well as seven relatively molecular markers, namely p15, p34, p53, p57, p73, survivin and nm23, were evaluated by immunohistochemistry and TUNEL in HCC tissues and compared to adjacent non-cancerous tissues and normal liver tissues. Furthermore, the prognostic significance by follow-up and mutual relationships for each clinicopathologic factor and molecular marker were analysed.Results: The dysregulation between proliferation and apoptosis and the abnormal expression of seven molecular markers were observed in HCC tissues. The unbalance of proliferation and apoptosis and abnormal expressions of p15, p34, p57 and nm23 were correlated with TNM stage and extrahepatic metastasis. In particular, the abnormal co-expression of nm23/p57 correlated with advanced TNM stage and bigger tumor size and was an independent prognostic factor of HCC.Conclusion: The unbalance of proliferation and apoptosis and abnormal expression of cell-cycle proteins promote metastasis of HCC. Moreover, the abnormal co-expression of nm23/p57 may be a useful molecular marker for metastasis and unfavourable prognosis for HCC. © 2010 The Japan Society of Hepatology.

Hlaing T.,Centro Hospitalar Conde Of Sao Januario | Yip Y.-C.,Kiang Wu Hospital | Ngai K.L.K.,Chinese University of Hong Kong | Vong H.-T.,Kiang Wu Hospital | And 4 more authors.
Journal of Medical Virology | Year: 2010

Macao is a densely populated city situated in East Asia where a relatively high prevalence of human papillomavirus (HPV) types 52 and 58 has been reported in women with invasive cervical cancer. To provide data for a population-specific estimation on the impact of HPV vaccines, paraffin-embedded tissues collected from women with invasive cervical cancer or cervical intrapeitheilal neoplasia grade 2 or 3 confirmed histologically were examined for HPV using the INNO-LiPa kit. Of the 35 HPV-positive patients with invasive cancer, one HPV type was detected in 68.6%, and 31.4% were co-infected with more than one HPV type. Overall, HPV 16, HPV 18, HPV 52, and HPV 54 were the most common types found respectively in 57.1%, 17%, 11.4%, and 8.5% of patients with invasive cervical cancer. Among the 59 HPV-positive patients with cervical intraepithelial neoplasia grade 2/3, 55.9% hardbored one HPV type, and 44.1% had co-infections. The common HPV types found included HPV 16 (52.5%), HPV 52 (23.7%), HPV 58 (18.7%), and HPV 33 (17%). Although HPV 11 (a low-risk type) was also found commonly in invasive cervical cancers (14.3%) and cervical intraepithelial neoplasia grade 2/3 (15.3%), the fact that they all existed as co-infections with another high-risk type suggested HPV 11 was not the cause of the lesion. The current vaccines targeting HPV 16/18 are expected to cover 62.9-74.3% of invasive cervical cancers and 32.2-55.9% of cervical intraepithelial neoplasia 2/3 in Macao. Widespread HPV vaccination is expected to reduce substantially the disease burden associated with cervical neoplasia in Macao. © 2010 Wiley-Liss, Inc.

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