Ovarian tumors complicating pregnancy

Administration of a sub-Tenon's anesthetic induced an orbital hemorrhage in a patient who underwent strabismus surgery. This report is the first case of this sight-threatening complication after sub-Tenon's infusion anesthesia.     

Ovarian cancer and borderline tumors

Long-term trends in the incidence, prognosis, and mortality of patients with ovarian cancer and borderline tumours in Norway were examined based on data from the population-based Cancer Registry of Norway. The incidence of ovarian cancer rose continuously from the mid-1950s to the mid-1980s. There was also an increasing trend in the incidence of borderline tumours from the early 1970s to the early 1990s. The prognosis for patients with ovarian cancer has improved since the 1950s. In 1989-93 the five-year relative survival rate was 37%. The prognosis for patients with borderline tumours was very favourable, with a five-year relative survival rate of 93% (1970-93). The mortality from ovarian cancer has been almost constant since the 1960s.     

Ovarian cancer complicating pregnancy

Ovarian cancer is the second most frequent gynecologic cancer complicating pregnancy. Although uncommon, this is a topic that encompasses multiple aspects of obstetrics and gynecology. The management of the adxenal mass in pregnancy, surgery for ovarian cancer, chemotherapy during gestation, and the use of tumor markers during pregnancy are discussed.     

Adrenal tumors and pregnancy

The lats gene has been identified as a tumour suppressor in Drosophila melanogaster using mosaic screens. Mosaic flies carrying somatic cells that are mutant for lats develop large tumours in many organs. The human LATS1 homologue rescues embryonic lethality and inhibits tumour growth in lats mutant flies, demonstrating the functional conservation of this gene. Biochemical and genetic analyses have revealed that LATS1 functions as a negative regulator of CDC2 (ref. 3). These data suggest that mammalian LATS1 may have a role in tumorigenesis. To elucidate the function of mammalian LATS1, we have generated Lats1-/- mice. Lats1-/- animals exhibit a lack of mammary gland development, infertility and growth retardation. Accompanying these defects are hyperplastic changes in the pituitary and decreased serum hormone levels. The reproductive hormone defects of Lats1-/- mice are reminiscent of isolated LH-hypogonadotropic hypogonadism and corpus luteum insufficiency in humans. Furthermore, Lats1-/- mice develop soft-tissue sarcomas and ovarian stromal cell tumours and are highly sensitive to carcinogenic treatments. Our data demonstrate a role for Lats1 in mammalian tumorigenesis and specific endocrine dysfunction.     

Ovarian germ cell tumors: an update

Study of an amorphous phase in plasma-sprayed hydroxyapatite (HA) coatings is important owing to its unique characteristics and nonnegligible amount of the amorphous phase compared to crystalline HA. However, little is known about the component parts of an amorphous phase. It is known that amorphous phase usually appears as the diffusion maximum (Dmax) in X-ray diffraction (XRD) patterns. Analyzing Dmax, including the position (Pmax) and area of Dmax, we can indicate the component parts of an amorphous phase and their transitions. In this study, the variation of Dmax in XRD patterns of the coatings during plasma spraying, in postheating, and in dissolving in vitro was studied with the aid of XRD. It was found that component parts of the amorphous phase in the coating varied with increasing thickness, consisting of two part represented by Dmax1, located between 29.4 and 29.8 degrees (2 theta), and Dmax2, located between 31.0 and 31.4 degrees (2 theta). It was concluded that Dmax3, located between 32.0 and 32.4 degrees (2 theta), should be referred to as nanocrystals of HA. In addition, the particle size of the starting powder may affect the component parts of the amorphous phase in the coating in addition to thickness. With vacuum heating (650 degrees C) and water vapor treatment at a low temperature (125 degrees C) in a saturated vaporic atmosphere, transition of the amorphous components was not as efficient as that at 490 degrees C with water vapor. The reason might be that the amorphous-to-crystalline HA conversion is dependent on both temperature and water vapor pressure. It was found that amorphous components were transformed completely into crystalline HA after heating at 490 degrees C with a partial water vapor pressure of 0.01 MPa for 2 h. It was concluded that the unstable amorphous components (Dmax1, Dmax2) converted into more stable nanocrystals of HA (Dmax3). Degradation in vitro showed that Dmax3 was more stable than Dmax1 and Dmax2. It was concluded that nucleation of apatite in vitro should be attributed to nanocrystals of HA (Dmax3) except for the amorphous components. It is recommended that the optimal phasic contents of the plasma-sprayed HA coating be mainly composed of crystalline HA and nanocrystals of HA (Dmax3) in terms of the stability and biocompatibility of the coating.     

Ovarian small cell tumors: an electron microscopic review

Small cell tumors of the ovary are uncommon but represent an important group to recognize in the differential diagnosis of primary and metastatic ovarian neoplasms. In some cases the correct diagnosis cannot be confidently made on the basis of clinical setting, routine light microscopy, and immunohistochemistry, and electron microscopy may be supportive or definitive in establishing cell type. The cell type is often important in choosing optimal therapy and in predicting prognosis. The authors performed electron microscopy on a moderate number of ovarian small cell tumors and here describe and illustrate the diagnostic features of representative examples of various types. The ultrastructural features of the metastatic tumors, such as embryonal rhabdomyosarcoma, neuroblastoma, and melanoma, are identical to those of their respective primary tumors, are well known, and usually pose no problem in diagnosis. On the other hand, the ultrastructural features of some primary ovarian small cell tumors may present a more difficult differential diagnosis, because they have features that are subtle and/or in common. Exemplary of tumors in this category are diffuse adult granulosa cell tumor, endometrial stromal sarcoma, and small cell carcinomas of the hypercalcemic and pulmonary (oat cell) types. Distinguishing among them may be difficult but is possible, and electron microscopy may be a valuable supplement to the diagnostic information obtained from the clinical presentation, light microscopy, immunohistochemistry and, in some tumors, cytometric analysis of these neoplasms.     

Ovarian cancer

Ovarian cancer is the leading cause of death in women with pelvic malignancies. Because of the multiple histologic types of malignancy that can arise within the ovary, accurate diagnosis and staging is critical for optimal patient care. The current standard of proper surgical management followed by combination chemotherapy is outlined. In addition, risk factors, screening, prognostic factors, and the approach to the relapsed patient is discussed.     

Ovarian neoplasia and subfertility treatments

OBJECTIVE: This study examines three specific questions about obesity and overweight, using a nationally representative sample of Canadians. Are sociodemographic and lifestyle behaviors associated with body weight? Is body weight correlated with specific health outcomes? Has the prevalence of obesity in Canada changed since 1978? METHODS: Secondary data analysis of a cross-sectional survey. SAMPLE: This study uses the 1994 National Population Health Survey (NPHS) by Statistics Canada. It is a stratified random sample of 19600 Canadians across all provinces. RESULTS: The results show that age, gender, education, birth place and region, are significantly associated with obesity. When a lower criterion is used for overweight and obesity (body mass index, BMI > or = 25), dummy variables for marital status and occupation are also significant. Second, obesity is associated with poorer self-rated health, high blood pressure, heart disease, diabetes, arthritis, respiratory and stomach problems. For those respondents who have a BMI score of 25 or greater, there is also an association with stroke. Finally, it is unclear whether the prevalence of obesity has changed. However, there appears to be a systematic difference between studies using actual height and weight measurements (anthropometric) vs self-reported measurements. CONCLUSIONS: Weight can be considered a modifiable risk factor and reductions in the prevalence of obesity should reduce the risk of specific chronic conditions. Provincial variations in the prevalence of obesity (BMI > or = 27) and overweight and obesity (BMI > or = 25) suggest that collapsing provinces into regions may obscure important inter-provincial differences in body weight. More research is required to assess whether or not obesity is decreasing in Canada. Some of the limitations of self-reported data are discussed.     

Ovarian hyperstimulation syndrome--prevention and treatment

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic, potentially life-threatening condition associated with ovulation induction. With increasing numbers of women receiving various ovarian stimulation protocols as part of different infertility treatments, the number of cases is likely to increase. The syndrome has a wide spectrum of clinical and laboratory findings, and is classified into mild, moderate and severe OHSS. The pathophysiology of this syndrome is unclear, and medical management has traditionally been conservative and supportive consisting of bedrest, volume expanders and replacement of fluid. When ascites is present, paracentesis under ultrasound guidance has been found to improve the condition of the patient by reducing the hydrostatic pressure. Prevention is very important, but at present it is doubtful if OHSS can be completely avoided due to the existence of a relatively small margin of safety between successful induction of ovulation and the development of OHSS.     

Ovarian cancer screening

Sperabillin polymers, which have been shown recently to have antitumor activity, are new basic peptidyl polymers composed of a pseudo-peptide antibiotic, sperabillin A. The polymers, HP-2 (MW 9990), AP-2 (MW 20,100) and AB-2 (MW 35,000), were found to potently activate murine peritoneal macrophages. The phagocytosis-dependent respiratory burst and Fc gamma receptor expression of peritoneal macrophages from C57BL/6 mice were enhanced after in vitro cultivation with these polymers. When HP-2, a representative of these polymers, was intraperitoneally injected into mice, the number of peritoneal exudate cells increased and phagocytosis-dependent respiratory burst and class II (I-A) antigen expression of peritoneal macrophages were augmented. These macrophages showed strong inhibitory activity against the growth of murine tumor cell lines such as EL4 lymphoma and B16 melanoma. Nitrogen oxide, tumor necrosis factor (TNF) and interleukin 1 (IL-1) might be required for this inhibitory activity. Moreover, in mice treated with HP-2, splenocyte counts also increased and non-specific killer activity of the splenocytes was augmented. These results indicate that sperabillin polymers are new macrophage activators.     

Ovarian vein syndrome

SETTING: A voluntary community health worker programme, in the Western Cape, South Africa, utilizing volunteers to administer directly observed therapy to tuberculosis (TB) patients. OBJECTIVE: This study describes the perceptions of health team members regarding the voluntary community health worker project. DESIGN: A qualitative, participatory research study utilizing focus groups. RESULTS: TB was perceived by the health team to be a stigmatized disease causing some patients to be reluctant to be associated with the TB control programme. Despite the project's dedicated approach to case-holding, volunteers expressed the need to develop skills in providing more comprehensive care. The volunteers appear to administer a more personalized service to TB patients and can bridge the gap between TB patients and the health agency. CONCLUSION: Sustained evaluation and support seem to be a vital tool in integrating a volunteer project into a health team approach. Its effectiveness appears to depend to a large degree on the people involved.     

Ovarian vein thrombosis

A 44 year-old woman was admitted with fever and lower abdominal pain at the right side suggestive of appendicitis. Ovarian vein thrombosis was diagnosed by sonography and confirmed by contrast-enhanced CT scan. After heparinisation the complaints disappeared and fever resolved in less than 72 hours. Repeated radiological investigation showed regression of the thrombus. Ovarian vein thrombosis is an uncommon, potentially fatal disorder that can be adequately treated with medication. The cornerstone of the diagnosis consists in non-invasive radiological investigation.