Three-dimensional sonography and hysterosalpingosonography in the diagnosis of uterine anomalies.

Uterine anomalies implicated in female subfertility, implantation failure and miscarriages can often be detected often by two-dimensional transvaginal (2D TV) ultrasound scanning. When used as a screening test TV ultrasound has provided sensitivity rates of up to 100% about uterine anomalies. Improved depiction has been achieved with the development of hysterosalpingosonography (HSSG). The anechoic interface provided by the saline solution allows the examiner to determine whether an abnormality is intracavitary, endometrial, or submucosal. The aim of this study was to evaluate the role of 2D TV contrast sonography and 3D TV ultrasound in the diagnosis of congenital uterine anomalies in comparison with their appearance of hysterosalpingosonography findings.

Postchemotherapy late recurrence of non metastatic gestational trophoblastic disease following a partiale mole. A case report.

The authors describe a case of a 35-year-old woman who showed elevation of betahCG 13 months after the complete regression of betahCG values following chemotherapy for an incomplete mole. This case outlines the necessity for careful monitoring of betahCG levels in low risk gestational trophoblastic diseases for a period of time longer than one year after achieving the first clinical remission.

[Ovulation induction and the risk of ovarian tumors]. / Induzione dell'ovulazione e rischio di neoplasie ovariche.

In the last years it has been observed a more and more increasing number of women submitted to therapies for induction of ovulation (disorders of the ovulation represent 33% of the causes of female infertility). In 1998, these therapies had been administrated to approximately two million of USA women. Various Authors have assumed a possible relationship between induction of ovulation and ovarian tumors. Between 1982 and 1997, at least 43 cases of ovarian tumors have been published (among these, there were also 25 cases of epithelial tumors) occurring in women previously treated with ovulation induction. The mean age of patient was 30.3 years, approximately 20 years younger than normal patient population for the same tumors. Among the possible causes of epithelial ovarian tumors, there is the trauma of the ovary surface caused by the continuous repeating of the ovulation phenomenon (incessant ovulation). Gynecologist should be aware of this potential risk for their patients. Multicentric studies should be evaluated in order to establish the risk of ovarian cancer in women treated for infertility problems. A survey of the international literature is made in order to analyse the epidemiological studies and to discuss the relationship between ovulation inducing agents and ovarian tumors.

[The role of the gynecologist in first aid in cases of sexual violence. A protocol proposal]. / Il ruolo del ginecologo di Pronto Soccorso nei casi di violenza sessuale. Proposta di protocollo.

The aim of this report is to provide a medical form to use in case of sexual assault, prepared taking into consideration the information lacking at present in most medical reports on the subject. This call for the necessity to conform the medical approach to the same protocol which may also be used from the forensic medicine point of view. More precise information should be obtained about the assault and the injuries inflicted, and also an immediate psychological support should be given to the victim. This information will then serve as a guide to the medical staff.

Pregnancy-associated breast cancer.

Pregnancy-associated breast cancer, which is defined as all breast cancer diagnosed during pregnancy or within the following year, is a relatively rare finding. Due to the particular difficulties in the diagnosis of breast cancer during this period, pregnant women tend to present more advanced disease at diagnosis. Four cases of pregnancy-associated breast cancer referred to our Institute are described as a contribution to the knowledge of this disease.

Survey of the deliveries of immigrant women from developing countries in the 2nd Institute of Gynaecology and Obstetrics, University of Rome, 'La Sapienza', Italy.

Five hundred and forty-four immigrant women, admitted from 1983 to 1993 to the 2nd Institute of Obstetrics and Gynaecology of Rome University, were enrolled in the study. Africa and East Europe were the most common places of birth. Seventy-five per cent of women gave birth spontaneously, and a caesarean section was performed in 22.2%. The frequency of spontaneous delivery and caesarean section was about the same among Italian and immigrant women.

Multiple primary neoplasms. Considerations on 42 cases.

During the years 1977-1993, 2,108 cases of gynecologic primary neoplasms were observed in the Department of Gynecology and Obstetrics of La Sapienza University in Rome. Forty-two cases were multiple primary cancers. Of these, 27 had multiple primary neoplasms involving only gynecologic sites, 15 had a neoplasm involving also another site; 3 patients had triple primary neoplasms. The most frequent neoplasm associations observed in our case series were: breast-ovary; endometrium-ovary; breast-cervix; endometrium-bowel (sigma-colon).

C-MYB activation and the pathogenesis of ovarian cancer.

We have detected the expression of the MYB proto-oncogene in ovarian cancer. This oncogene was thought to be expressed in a tissue-specific manner in cells of hematopoietic lineage. Total RNA from three established cell lines and four human primary ovary cancers was examined by Northern and Southern blot, RNAse protection, in situ hybridization and cytogenetic analysis. A 3.8 kb RNA transcript was present in one human primary cell culture which is the same size as that found in the immature myeloid HL60 cell line. No expression was detected in normal ovary tissue. Southern blot analysis of DNA from five ovarian tumors indicated that this gene is not rearranged. Chromosomal analysis of three samples show many abnormalities in two cases and a normal karyotype in another one. The presence of MYB transcript in ovarian cancer suggests that MYB may play a specific role in the pathogenesis of this disease.

Chemosensitivity and DNA content as prognostic factors in ovarian cancer: preliminary results.

Fourteen samples of epithelial ovarian cancer were studied; chemosensitivity in vitro was examined by clonogenic assay, and DNA content was measured by static cytometry. Seven cases were aneuploid. The average survival of the diploid cases was almost twice that of the aneuploid cases (21 vs 11 months). Five of the 7 diploid, and 4 of the aneuploid cases were chemosensitive in vitro; 4 diploid and 3 aneuploid tumors were sensitive in vivo. The vitro/vivo correlation was positive for 6 out of 7 aneuploid tumors, and for 4 out of 7 diploid cases. Patients sensitive in vitro to at least one of the two drugs tested responded more often to chemotherapy, whatever drugs were used in vitro. The patients whose 5 C exceeding rate was 10% survived 12 months at most, with an average survival of 8 months; patients with a low aneuploidy index survived an average of 20 months. The behavior of the diploid tumors in vitro was more varied. Ploidy would seem to be an additional factor to other parameters of prognosis, while no correlation is evident between chemosensitivity in vitro, D.I., and 5 C exceeding rate.

Ovarian cancer: relationship between in vitro chemosensitivity and clinical response.

Thirty-nine samples from 30 patients with epithelial ovarian cancer were collected. Using the method described by A. Hamburger (J. Natl. Cancer Inst. 66, 981 (1981] and P. Salmon et al. (N. Engl. J. Med. 308, 129 (1983], tumor cells were exposed to antineoplastic agents (Adriamycin and cis-platinum) and then cultured in double-layer agar. There were 23 evaluable patients. The percentage of complete and partial responses for patients whose cells were sensitive in vitro, whether or not treated with the same drugs, was 68, vs 44% compared to patients whose cells were resistant in vitro and treated in vivo with therapeutic regimens which may or may not have included drugs used in the test. More patients with residual tumor greater than 2 cm were resistant to chemotherapy.