Taiwanese journal of obstetrics & gynecology
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Cervical cancer is not only the most frequently reported cancer among women, but also the most common female genital tract neoplasm in Taiwan. Early detection is effective, because the development, maintenance and progression of precursor lesions (cervical intraepithelial neoplasia [CIN]) evolve slowly into invasive cancer, typically over a period of more than 10 years. ⋯ The prevention of HPV infection before the onset of CIN is now possible with recently available prophylactic HPV vaccines, e.g. the quadrivalent Gardasil (Merck & Co., NJ, USA) and bivalent Cervarix (GlaxoSmithKline, London, UK). This review article provides an up-to-date summary of recent studies and available information concerning HPV and vaccination in cervical cancer.
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Taiwan J Obstet Gynecol · Jun 2007
Case ReportsGestational thrombocytopenia complicated with macrosomia, failure to progress in active labor, and postpartum hemorrhage.
Gestational thrombocytopenia is a rare event, and the etiology is unknown. Generally, there is no need for intervention because of the absence of coagulopathy. However, when complicated with other obstetric conditions, care should be taken to prevent a dangerous cascade. Here, we present a patient with severe gestational thrombocytopenia complicated with macrosomia, failure to progress in active labor, and severe postpartum hemorrhage after cesarean section. ⋯ Gestational thrombocytopenia does not usually require treatment if there is no bleeding tendency. However, when other bleeding complications are present, it may exacerbate coagulopathy and exhaust the platelet reserve, thereby worsening the condition. If surgical intervention cannot be avoided, blood and platelet transfusion before a cesarean delivery is highly recommended in severe gestational thrombocytopenia.
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Taiwan J Obstet Gynecol · Mar 2007
ReviewHuman umbilical cord blood cells or estrogen may be beneficial in treating heatstroke.
This current review summarized animal models of heatstroke experimentation that promote our current knowledge of therapeutic effects on cerebrovascular dysfunction, coagulopathy, and/or systemic inflammation with human umbilical cord blood cells (HUCBCs) or estrogen in the setting of heatstroke. Accumulating evidences have demonstrated that HUCBCs provide a promising new therapeutic method against neurodegenerative diseases, such as stroke, traumatic brain injury, and spinal cord injury as well as blood disease. More recently, we have also demonstrated that post- or pretreatment by HUCBCs may resuscitate heatstroke rats with by reducing circulatory shock, and cerebral nitric oxide overload and ischemic injury. ⋯ Another line of evidence has suggested that estrogen influences the severity of injury associated with cerebrovascular shock. Recently, we also successfully demonstrated estrogen resuscitated heatstroke rats by ameliorating systemic inflammation. Conclusively, HUCBCs or estrogen may be employed as a beneficial therapeutic strategy in prevention and repair of cerebrovascular dysfunction, coagulopathy, and/or systemic inflammation during heatstroke.
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Taiwan J Obstet Gynecol · Mar 2007
Case ReportsLarge cell neuroendocrine carcinoma of the uterine cervix associated with adenocarcinoma.
Large cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive cervical neoplasm. In the present study, we present a 45-year-old woman with large cell neuroendocrine uterine cervical carcinoma with coexisting adenocarcinoma. ⋯ Patients with LCNEC of the cervix have had poor prognoses; hence aggressive multimodality treatment is recommended.