Rorschach correlates of self-reported attachment dimensions: dynamic manifestations of hyperactivating and deactivating strategies.

We examined associations between self-reported attachment anxiety and avoidance and responses to the Rorschach test. Seventy-two, nonpatient Israeli adults participated in a 2-session study. In the first session, they completed a self-report scale tapping the dimensions of attachment anxiety and attachment avoidance. In the second session, they completed the Rorschach test. The Rorschach was administered and coded according to Exner's (2001) Comprehensive System scoring. We found that self-reports of attachment anxiety were associated with Rorschach scores thought to indicate difficulties in regulating and controlling emotions and self-perceptions of being relatively helpless and unworthy. Self-reports of attachment avoidance were associated with Rorschach scores thought to reflect lack of acknowledgment of need states and maintenance of a grandiose self. We discuss the findings in terms of implicit psychodynamic processes inherent in attachment-system functioning.

Cystectomy for immature teratoma of the ovary.

OBJECTIVES: Most patients with malignant ovarian germ cell tumors (MOGCT) of the ovary are in their reproductive years and wish to preserve fertility. Because of the excellent response to chemotherapy, the standard of care is unilateral salpingo-oophorectomy (USO), but some patients undergo cystectomy only before final pathology. In view of the lack of information concerning the outcome following cystectomy in germ cell tumors, we retrospectively evaluated the clinical outcome of patients who underwent cystectomy only as part of their surgical treatment. METHODS: The clinical and pathological records of 38 patients diagnosed with MOGCT, treated and followed in the department of gynecologic oncology were reviewed. Eight patients underwent cystectomy only at their initial surgery and are the subjects of this study. RESULTS: All the eight patients who underwent cystectomy were diagnosed with immature teratoma (three grade 1, four grade 2, and one grade 3) on final pathology following surgery. All except three patients (two with grade 1 and one with grade 2 disease) received adjuvant chemotherapy. Follow-up was available for all the patients, with a median duration of 4.7 years. No recurrences were observed during this period. Three patients delivered a total of seven babies. CONCLUSIONS: Cystectomy followed by adjuvant chemotherapy appeared satisfactory for apparent early-stage immature teratoma when close follow-up was carried out. It is still unclear whether cystectomy alone will also be safe. Further studies will need to address this issue.

Outcome of fertility-sparing treatment with progestins in young patients with endometrial cancer.

OBJECTIVE: To evaluate the safety of fertility-sparing hormonal therapy for endometrial cancer in young patients. METHODS: We reviewed the clinical and pathologic records of patients diagnosed with endometrial adenocarcinoma before the age of 40, who were treated and followed over a 30-year period in the Division of Gynecologic Oncology. All patients who underwent conservative management with progestins (n = 13) are the subjects of this study. RESULTS: Follow-up was available for all 13 patients, with a mean follow-up of 82 months. All patients responded to treatment within a mean period of 3.5 months, with normal pathology on follow-up endometrial samplings. Six patients had a recurrence within a period extending between 19 and 358 months (median 40 months). Four patients were treated with a second course of progestins, and all had a histologic complete response. As of the time of preparation of this report, nine healthy infants had been born, and all the patients remained without evidence of disease. CONCLUSION: Conservative management of well-differentiated endometrial carcinoma in young patients, combined with assisted reproductive technologies, if needed, does not seem to worsen the prognosis. This approach also provides the possibility of conceiving and carrying a normal pregnancy.