Analysis of the treatment of ovarian cancer patients with neo-adjuvant chemotherapy--preliminary results.

INTRODUCTION: Primary surgery and adjuvant chemotherapy is the standard treatment in ovarian cancer patients. Neo-adjuvant chemotherapy is one of the treatment modes in patients with a poor general condition or advanced disease, not adjustable for primary surgery. The purpose of this study was to evaluate if the efficacy of this new option of therapy is comparable to the standard method. MATERIALS AND METHODS: 319 ovarian cancer patients, FIGO Stage III and IV, have been analyzed. Within this group, 50 women were treated with neo-adjuvant chemotherapy. 18 patients were operated after three cycles of neo-adjuvant chemotherapy, and 32 patients--after six cycles. Results of treatment were evaluated, including disease-free survival, and number of complications. Factors that may influence the treatment results were also analyzed. RESULTS: Median disease-free survival in the group treated with adjuvant chemotherapy (group 3), and operated on after three cycles of neo-adjuvant chemotherapy (group 1), were 19 and 20 months, respectively. For the group operated on after six cycles of neo-adjuvant chemotherapy (group 2), median disease-free survival was 15 months (p = 0.27). The following factors have been found to influence treatment results: optimal cytoreduction and tumor grading. There was no difference in complication rates among the three analyzed groups.

[Monitoring the quality of obstetric care]. / Monitorowanie jakosci opieki polozniczej.

The aim of this study was to analyse some aspects and methods use to evaluate the quality of obstetric care, and their implementation into obstetric practice. Assurance of proper quality of services in obstetrics becomes today a key -problem in Poland. The article describes the evaluation of structures, processes, and results as methods of quality assurance and control. Authors suggest that special attention should by paid to correct leader- ship, medical records analysis and later formulating constructive conclusions and quality improvement. Audit and quality improvement at the national level seems to be very important. Monitoring of quality is not only necessary, but also continuous management and improvement. It is also necessary to remember that the process of quality improvement once begun should be continued.

Assessment of adolescent varicocele.

Varicocele is the most important male factor responsible for decreased fertility potential in married couples. From March through June 1994, 2,470 school boys aged 10-20 years were examined to establish the incidence of consecutive grades of varicocele and to develop a protocol for diagnosis and treatment of adolescents with varicocele. Grade 1 varicocele was found in 18%, grade 2 in 12%, and grade 3 in 5% of the population examined. An original protocol of ultrasonographic (US) examination (previously verified by angioscintigraphy) was introduced to assess boys with clinically diagnosed varicocele. The volume of each testis, testicular volume decrease (TVD), pampiniform vein diameter (PVD), and basal (BBF) and maximum blood flow (MBF) velocities were measured in 625 boys. In 74 cases a semen analysis was performed. The statistical analysis revealed that the presence of venous reflux and PVD correlated with the grade of varicocele. Decreases in testicular volume were highly dependent on the grade of varicocele, PVD, and BBF and MBF velocities. Analysis of the relationship between spermatic (boys over 17 years) and US findings revealed that the quality of spermatogenesis can be predicted by US examination in adolescents with varicocele. The authors recommend multiparametric US examination as a reliable, objective, and repeatable technique for establishing criteria for operative treatment in boys under 18 years of age with varicocele as well as for postoperative evaluation.

Specific inhibition of vaccinia virus growth by 2'-O-methyladenosine: isolation of a drug-resistant virus mutant.

2'-O-methyladenosine (Am) specifically inhibits growth of vaccinia virus on cultured monkey kidney (BSC40) cells. Specificity has been demonstrated by the isolation of an Am-resistant mutant of vaccinia which forms plaques on Am-treated monolayers of BSC40 cells under conditions where wild type (wt) plaque formation is inhibited. Am inhibits virus growth at an early stage of infection; host shut off and early virus protein synthesis are inhibited by the drug.