ABSTRACT: Bleeding angiomyolipomas in pregnancy are rare but may be devastating and potentially fatal. In previous cases, most of these lesions have been managed with urgent nephrectomy or embolization. Only one other case report describes treating these lesions through conservative management and vaginal delivery.
A 32-year-old woman with known bilateral angiomyolipomas presented at 39 weeks of gestation with acute onset left flank pain. The ultrasound result was consistent with a bleeding angiomyolipoma. The patient was otherwise hemodynamically stable and was managed safely in a conservative outpatient approach that consisted of close clinic follow-up, serial hemoglobins, ultrasound studies, and vaginal delivery.
Bleeding angiomyolipomas in pregnancy were managed successfully through conservative management and vaginal delivery.
Obstetrics and Gynecology 03/2006; 107(2 Pt 2):490-2. · 4.73 Impact Factor
ABSTRACT: To determine the temporal relationship between the increase in bladder mass and the expression of growth-associated gene products during bladder hypertrophy due to partial bladder outlet obstruction.
Adult female rats, subjected to partial bladder outlet obstruction, were killed at defined points, and their bladder weight and total protein were determined and compared with sham-operated and nonoperated controls. Hyperplasia was determined by the expression of proliferating cell nuclear antigen, transcription factors, and cyclins in obstructed rat bladders. Bladder protein was fractionated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and expression of the indicated proteins was determined by Western analysis and immunohistochemistry.
The mean bladder weight in sham-operated rats remained at 127 +/- 17 mg, and the weight in the obstructed animals increased to 239 +/- 56 mg at 12 hours, increasing to 486 +/- 168 mg by 168 hours. The total bladder protein increased 1.8-fold after 12 hours and continued to increase for the duration of obstruction. The expression of proliferating cell nuclear antigen in the obstructed group did not begin until 24 hours of obstruction. The expression of the transcription factors, upstream binding factor, and c-Jun followed a similar pattern. Cyclin E and C expression increased most significantly after 48 hours.
Bladder growth after 12 hours of partial outlet obstruction represents cellular hypertrophy based on the increases in bladder weight and total protein accumulation. Cellular hyperplasia occurs after 24 hours of obstruction as represented by increases in transcription factors and cell cycle-specific proteins.
Urology 07/2002; 59(6):978-82. · 2.43 Impact Factor
ABSTRACT: Fragile X syndrome (FraX) is the most common hereditary form of mental retardation. The clinical syndrome includes mental retardation, macroorchidism, and typical but variable facial features. Although macroorchidism has been recognized as a cardinal feature of FraX, descriptions of testicular pathology are rare. Testicular torsion is a relatively common surgical emergency in young men, peaking at the onset of puberty when the testes undergo a period of rapid growth. However, testicular torsion has never been associated with macroorchidism. We report the first known case of testicular torsion in a 14-year-old boy with FraX and macroorchidism. Although we are unable to establish a definitive relationship between macroorchidism and testicular torsion in an isolated case report, primary care takers of children with macroorchidism should be aware of this occurrence. We recommend measurement of testicular volume during annual evaluations of children and adolescents with macroorchidism. Acute scrotal pain or increased testicular volume should be promptly evaluated.
PEDIATRICS 02/2002; 109(1):E16. · 4.47 Impact Factor