Application and internal validation of lung ultrasound score in COVID-19 setting: The ECOVITA observational study.

BACKGROUND: The severe acute respiratory syndrome Coronarovirus-2 associated still causes a significant number of deaths and hospitalizations mainly by the development of respiratory failure. We aim to validate lung ultrasound score in order to predict mortality and the severity of the clinical course related to the need of respiratory support. METHODS: In this prospective multicenter hospital-based cohort study, all adult patients with diagnosis of SARS-CoV-2 infection, performed by real-time reverse transcription polymerase chain reaction were included. Upon admission, all patients underwent blood gas analysis and lung ultrasound by expert operators. The acquisition of ultrasound scan was performed on 12 peculiar anatomic landmarks of the chest. Lung ultrasound findings were classified according to a scoring method, ranging 0 to 3: Score 0: normal A-lines. Score 1: multiple separated B-lines. Score 2: coalescent B-lines, alteration of pleural line. Score 3: consolidation area. RESULTS: One thousand and seven patients were included in statistical analysis (male 62.4 %, mean age 66.3). Oxygen support was needed in 811 (80.5 %) patients. The median ultrasound score was 24 and the risk of having more invasive respiratory support increased in relation to higher values score computed. Lung ultrasound score showed negative strong correlation (rho: -0.71) with the P/F ratio and a significant association with in-hospital mortality (OR 1.11, 95 %CI 1.07-1.14; p < 0.001), even after adjustment with the following variables (age, sex, P/F ratio, SpO2, lactate, hypertension, chronic renal failure, diabetes, and obesity). CONCLUSIONS: The novelty of this research corroborates and validates the 12-field lung ultrasound score as tool for predicting mortality and severity clinical course in COVID-19 patients. Baseline lung ultrasound score was associated with in-hospital mortality and requirement of intensive respiratory support and predict the risk of IOT among COVID-19 patients.

Rarebit perimetry and frequency doubling technology in patients with ocular hypertension.

PURPOSE: To test the capability of rarebit perimetry (RP), a recent non-conventional perimetric technique, in detecting early functional damage in subjects with ocular hypertension (OHT) and to compare RP findings with those obtained by frequency-doubling technology (FDT) perimetry. METHODS: Thirty patients with OHT were matched with 30 healthy subjects. All were tested with RP and FDT. Frequency-doubling technology mean deviation (MD) and pattern standard deviation (PSD), as well as RP mean hit rate (MHR), of the two groups were analyzed. The agreement between the two techniques was tested by Kappa analysis. RESULTS: In the OHT group the mean (SD) FDT MD was 0.5 (2.1), the mean (SD) FDT PSD was 4.2 (1.6), and the mean (SD) RP MHR was 81.4 (6.7). In the control group, corresponding values were mean (SD) FDT MD 1.1 (1.4), mean (SD) FDT PSD 3.0 (0.3), mean (SD) RP MHR 96.2 (2.0). The differences between the two groups were not significant for the studied indexes. Eleven (36.6%) out of the 30 OHT eyes had abnormal RP results; 12 (40.0%) eyes had abnormal FDT results. Five (16.6%) eyes had abnormal RP and FDT findings. Only 1 eye (3.3%) in the control group had abnormal RP results and 3 eyes (10.0%) had abnormal FDT results. RP and FDT showed a moderate agreement (Kappa=0.43; 95% CI: 0.42 to 0.51). CONCLUSIONS: RP and FDT showed VF defects not shown in standard automated perimetry in the OHT group. This may be indicative of an increased risk in developing glaucoma, even if a gold standard for detecting subtle defects is not currently available. RP has the additional advantage of not requiring any expensive device to be used. The poor agreement between these techniques in identifying eyes with early damage warrants further investigations. Large longitudinal studies are needed before defining the role of RP in early glaucoma diagnosis.

The effect of pneumatic trabeculoplasty on intraocular pressure: the results of a 6-month, open-label, multicenter study.

PURPOSE: To evaluate the effects of pneumatic trabeculoplasty (PNT) in ocular hypertension and glaucoma subjects. METHODS: A total of 63 consecutive subjects, either treated (79%) or untreated (21%), with intraocular pressure (IOP) between 20 and 25 mmHg were enrolled; the eye with higher IOP (or, in case of identical IOP, worse visual field) was treated with PNT, with the fellow eye used as control. Subjects underwent a baseline evaluation the day before treatment, two PNT treatments at day 0 and 7, visits at day 1, 8, 14, and at each month until the end of the study, which lasted 6 months. Safety was addressed at all visits; an IOP curve (at 8 and 10 AM, 2 and 4 PM) was obtained at baseline and during monthly visits. RESULTS: In PNT eyes, baseline IOP was 22.2-/+1.6 mmHg. Following PNT a statistically significant reduction of IOP occurred at all visits (p<0.0001), with a mean decrease ranging from -2.7-/+2.5 (-11.9-/+10.8%) to -3.6-/+2.6 mmHg (-16.0-/+11.6%); mean reduction was 12.8-/+11.5%. Although IOP diminished also in the control eyes after baseline (p<0.05), the change in IOP was significantly higher in PNT group at each visit (p<0.05). Mild side effects were experienced by 76% of subjects and they all resolved without sequelae. CONCLUSIONS: The results suggest the effect of this procedure in reducing IOP in glaucoma and ocular hypertensive subjects.

Sector-based analysis of frequency doubling technology sensitivity and optic nerve head shape parameters.

PURPOSE: To evaluate which Heidelberg Retina Tomograph (HRT) parameter is the best predictor of frequency doubling technology (FDT) sensitivity by using a sector based analysis between FDT and optic nerve head shape parameters such as cup shape measure (CSM) and rim area (RA), which have been shown to have the best correlation with FDT indices among all the HRT parameters. METHODS: One eye was randomly chosen from 100 patients with primary open angle glaucoma (abnormal visual field and/or abnormal optic nerve and untreated intraocular pressure above 21 mm Hg). All the patients were examined with Humphrey field analyzer (HFA), program 24-2, SITA standard, FDT program C 20, and HRT. RA and CSM for the HRT analysis and mean deviation, pattern standard deviation, and the sensitivity of each tested point for the FDT test were considered in this study. All the parameters were calculated as both global and sector measurements. Findings were analyzed using Pearson's correlation coefficient and linear regression model. RESULTS: Significant (p<0.001) correlation was found between FDT indices and HRT RA and CSM. Significant (p<0.001) sector correlation was found between FDT sensitivity and RA and CSM, but when a linear regression model was applied, RA was the most predictive parameter of FDT. Temporal CSM was more strongly correlated to FDT fovea sensitivity than temporal RA. Furthermore, sector HRT parameters were better correlated to HFA than to FDT. CONCLUSIONS: In this glaucomatous group, cup shape measure and RA were significantly correlated to FDT indices. RA was more predictive of FDT abnormality than CSM in all the considered sectors except in the temporal one. However, HFA was a stronger predictor of HRT parameters than FDT.

Retinal pigment epithelial tear following intravitreal injection of bevacizumab (Avastin).

PURPOSE: To report one case of retinal pigment epithelium tear following intravitreal bevacizumab injection for neovascular age-related macular degeneration. METHODS: A 59-year-old patient presented with occult choroidal neovascularization associated with a serous pigment epithelial detachment secondary to age-related macular degeneration. The patient was treated with an intravitreal injection of bevacizumab. RESULTS: The patient developed a retinal pigment epithelium tear 60 days following the intravitreal injection. CONCLUSIONS: This report describes the development of retinal pigment epithelium tear after intravitreal bevacizumab injection. Future studies should be performed to evaluate which subtypes of lesions are most susceptible to this potential devastating visual complication.

Intravitreal triamcinolone acetonide as primary treatment for diffuse diabetic macular edema: a prospective noncomparative interventional case series.

PURPOSE: To evaluate the efficacy and safety of one intravitreal injection of 25 mg of triamcinolone acetonide as primary treatment for diffuse diabetic macular edema. METHODS: Intravitreal triamcinolone acetonide injection was performed in 30 eyes with previously untreated diabetic macular edema. The main outcome measures were logMAR visual acuity (VA) and central macular thickness (CMT) at 1, 3, and 6 months. A secondary outcome was intraocular pressure progression. RESULTS: Visual acuity results for 30 eyes that had a follow-up of at least 6 months are presented. Twenty of them were followed up to 10.1+/-2.38 months. Preoperatively, VA was 0.54+/-0.27. At 1, 3, and 6 months follow-up, VA was 0.44+/-0.29 (p=0.001), 0.43+/-0.28 (p=0.001), and 0.45+/-0.29 (p=0.006), respectively. Preoperatively, CMT was 417.3+/-143.5 microm. At 1, 3, and 6 months follow-up, CMT was 277.3 +74.0 microm (p<0.0001), 279.6+/-94.4 microm (p<0.0001), and 297.07+/-114.87 microm (p=0.002), respectively. For the 20 eyes with a follow-up of 10.1+/-2.38 months, VA was 0.5+/-0.25 and 0.50+/-0.32 at baseline and at the last follow-up visit, respectively (p>0.05). Preoperatively, intraocular pressure (IOP) was 15.13+/-1.48 mmHg. IOP was 18.26+/-2.71 mmHg, 20.07+/-4.27 mmHg, and 20.4+/-6.18 mmHg, at 1, 3, and 6 months, respectively (p<0.0001). Four eyes underwent uncomplicated filtrating surgery for intractable glaucoma. CONCLUSIONS: Intravitreal triamcinolone as primary treatment effectively increases VA and reduces CMT due to diffuse diabetic macular edema. Longer follow-up and randomized clinical trial are warranted. Safety results highlight the need to further study the relationship between triamcinolone and intraocular pressure.

Intravitreal triamcinolone in the treatment of serous pigment epithelial detachment and occult choroidal neovascularization secondary to age-related macular degeneration.

PURPOSE: To report two cases of occult choroidal neovascularization (CNV) and serous pigment epithelial detachment (PED) treated with intravitreal triamcinolone (IVT) injections. METHODS: Interventional case reports. RESULTS: Both patients showed an increase in visual acuity and a complete flattening of the PED at 10 months (Case 1) and 4 months (Case 2) after IVT injections. No complications or adverse effects are reported. CONCLUSIONS: Future studies should be designed to investigate if IVT can effectively influence the clinical and functional outcome of eyes with serous PED and occult CNV secondary to age-related macular degeneration, for which at the moment no treatment has been shown to be effective.

Multiple bilateral choroidal metastatic tumors from a small-cell neuroendocrine carcinoma of unknown primary site.

PURPOSE: To report one case of multiple and bilateral choroidal tumors from a poorly differentiated small cell neuroendocrine carcinoma of unknown primary. METHODS: The case of a 30-years-old white female who developed multiple and bilateral choroidal tumors from a poorly differentiated small cell neuroendocrine carcinoma of unknown primary is presented. RESULTS: The patient had a disseminated disease and died 6 months after. The oncologic work-up, including physical examination, laboratory and radiographic study, fails to identify the primary site. CONCLUSIONS: Intraocular involvement from a poorly differentiated small cell neuroendocrine carcinoma of unknown primary has not yet reported. We describe this case together with a review of the literature.

Conventional perimetry, short-wavelength automated perimetry, frequency-doubling technology, and visual evoked potentials in the assessment of patients with multiple sclerosis.

PURPOSE: To evaluate the diagnostic power of conventional, achromatic, automated perimetry (CAP), short-wavelength automated perimetry (SWAP), frequency-doubling technology (FDT) perimetry, and visual evoked potentials (VEP) in a group of patients with multiple sclerosis (MS) with or without a history of optic neuritis. METHODS: Thirty eyes of 15 patients (5 male, 10 female, average age 38+/-7 years) with confirmed diagnosis of MS underwent CAP, SWAP (Humphrey 750-II VFA, program central 30-2, full-threshold strategy), FDT perimetry (program N-30), and pattern VEPs. Sixteen eyes (53.3%) had no history of ocular involvement and a negative ophthalmologic examination. They were matched with a control group of 10 healthy volunteers (4 male, 6 female, average age 31+/-10 years). The mean deviation (MD) and the pattern standard deviation (PSD) of the two groups were compared (t-test). Fourteen eyes (46.7%) had, on the contrary, a history of optic neuritis. Inside this group, the MD and the PSD of the three techniques were correlated (Spearman's rank test), in order to investigate whether any significant differences might be revealed by these techniques in pointing out the total amount of visual field damage. RESULTS: When comparing MS patients without signs or symptoms of ocular involvement and a control group, no significant differences were found for CAP MD, CAP PSD, and FDT PSD. Significant differences were found, on the contrary, for SWAP MD (p=0.0014), SWAP PSD (p=0.0001), and FDT MD (p=0.0001). When considering the MD and the PSD of the three techniques in the group of MS patients who had a history of optic neuritis, a significant correlation was found only between CAP MD and SWAP MD (r=0.0057), with a tendency by SWAP to reveal a higher rate of visual field loss. The other correlations were not significant. According to predefined criteria, the group of asymptomatic subjects had abnormal CAP in 1 eye (6.25%), abnormal SWAP in 9 (56.2%), abnormal FDT in 11 (68.7%), and abnormal VEPs in 7 (43.7%). The combined use of all techniques allowed us to identify silent optic nerve impairment in 15 (93.7%) eyes. CONCLUSIONS: Short-wavelength automated perimetry and FDT perimetry are two non-conventional perimetric techniques that were mainly developed for the early detection of glaucomatous damage. The results of this study demonstrate their efficacy also in detecting early visual field deficits in MS patients without clinical signs of optic neuropathy. Frequency doubling perimetry, in particular, proved to be an easy, fast, and sensitive technique in the assessment of patients with MS. Our results also suggest that subclinical visual involvement in MS can be better diagnosed using multiple (neurophysiologic and psychophysical) tests.

Branch retinal artery occlusion combined with branch retinal vein occlusion in a patient with hepatitis C treated with interferon and ribavirin.

PURPOSE: To report a case of a combined branch retinal artery and vein occlusion in a patient with hepatitis C treated with interferon and ribavirin. METHODS: A 29-year-old man with a 1-week history of sudden visual field defect and decrease of central visual acuity was examined. RESULTS: Ophthalmoscopy and fluorescein angiography demonstrated an ischemic whitening of the inferior hemi-retina involving part of the macular region, numerous intraretinal hemorrhages, and a significant delay in arterial and vein filling of the dye. CONCLUSIONS: The findings of a retinopathy associated with interferon and ribavirin treatment of hepatitis C are important. The symptomatic permanent visual field defect and decrease of central visual acuity developing following a branch retinal artery and vein occlusion event emphasizes the need for careful and regular ocular monitoring of patients receiving interferon for hepatitis C.

RA/DA cumulative curve analysis of local and diffuse neuroretinal rim area damage in glaucoma patients.

AIM: To evaluate the validity of cumulative rim/disc area (RA/DA) curve analysis as a clinical tool for the identification of glaucoma induced optic disc pathology. METHODS: 71 normal and 83 glaucomatous eyes were evaluated from a series of 154 subjects recruited for this study. For each eye, the cumulative distribution of RA/DA was calculated from 36 equally spaced rim sectors of each optic disc obtained by the automatic evaluation of simultaneous videographics (Image-net X Rev.3/51b). To increase the sensitivity of this analysis in early glaucoma and in normal eyes, these cumulative curves were subsequently divided into two equal segments and the slopes of their respective regression lines compared. RESULTS: The median RA/DA value obtained from the 36 sectors was significantly different in glaucomatous eyes compared with normals (p < 0.001). Nevertheless, the curves (5th-95th percentile of the cumulative curves distribution) of early glaucomatous eyes fell within the normal range. When the cumulative curve of these marginal cases was then divided into two equal segments, the comparison of the slopes of the regression lines showed a significant difference (p < 0.05) in 100% of early glaucomatous eyes. Furthermore, normal eyes were shown to be true negatives in 93% of the cases in which no significant difference between the two slopes was observed. CONCLUSION: Analysis of the RA/DA cumulative curve from 36 sectors of the optic disc was a valid method for the identification of glaucomatous disc pathology; however, a further calculation of the slopes of the two RA/DA regression lines was needed to identify early glaucomatous damage.

Daily tonometric curves after cataract surgery.

AIM: To evaluate daily tonometric curves after cataract surgery in patients with cataract only and in patients with cataract and glaucoma. METHODS: 108 patients scheduled for cataract surgery were randomly allocated to two groups: 57 patients with cataract only (normal) and 51 with cataract and primary open angle glaucoma (POAG). All patients underwent extracapsular cataract extraction (ECCE) (manual technique with long wound), phacoemulsification (automated technique with short wound), or nucleus capture (manual technique with short wound). Intraocular pressure (IOP) was measured by Goldmann tonometry in all patients every 2 hours for 12 hours before the operation and at 1 and 6 months postoperatively. RESULTS: 79 patients completed the 6 month examination. ECCE resulted in greater reductions in IOP than the other procedures (ECCE: 27% and 36% in normal patients and those with POAG, respectively; nucleus capture: 20% and 31%, respectively; phacoemulsification: 19% and 22%, respectively). The fluctuations in IOP before and after surgery were not statistically significant. CONCLUSION: Cataract surgery in normal patients reduces IOP but does not eliminate fluctuations which are directly proportional to the IOP value and result partly from circadian rhythms. This important finding might influence our approach to treatment of patients with glaucoma.

Paclitaxel and carboplatin as outpatient therapy for stage III and IV epithelial ovarian cancer.

BACKGROUND: To determine the toxicity and the response rate of a three-hour paclitaxel infusion and carboplatin administered as outpatient treatment for stage III and IV epithelial ovarian cancer. METHODS: Forty-three patients with stage III/IV epithelial ovarian cancer underwent cytoreductive surgery and then received paclitaxel 175 mg/m2 over 3-hr infusion and carboplatin AUC5 every 21 days for six cycles. Elegible patients had adequate bone marrow, renal and hepatic function; G-CSF was recommended if white cell count fell under 3,000/mm3. RESULTS: No patients had hypersensivity reactions; 15 out of 43 patients (35%) required colony-stimulating factors, 39 patients (91%) had general alopecia, three patients (7%) had severe emesis, 20 patients (46%) had mild emesis, four patients (9%) had severe myalgias, eight patients (18%) had moderate myalgias, one patient (2%) had grade 3 neurotoxicity. Three patients experienced grade 3 thrombocytopenia (7%). At a median follow-up of 29 months, 32 of 43 patients are alive (74%). Median progression-free survival is 14 months. Median overall survival has not been reached. CONCLUSIONS: Three-hour infusion paclitaxel and carboplatin is an effective and safe outpatient therapy for epithelial ovarian cancer.

Low spatial-contrast sensitivity in dry eyes.

PURPOSE: Blurred vision in keratoconjunctivitis sicca eyes could be the result of the loss of the glossy surface of the tear film because of changes in composition or thickness irregularities. Spatial-contrast sensitivity in keratoconjunctivitis sicca and normal control eyes was tested before and after a tear substitute. METHODS: Three different groups of subjects were enrolled: one group of dry eyes with nonsignificant signs of epithelial disease (n = 12), the second group of dry eye positive with 1% Bengal rose staining of the cornea and of the conjunctiva (n = 18), and a third of normal eyes as control group (n = 15). In all the 45 eyes, spatial-contrast sensitivity was tested under the best correction by means of the Vistech Multivision Contrast Tester 8000 (Vistech Consultants, Dayton, OH, U.S.A.) before and 15 min after the instillation of a 0.4% Na-hyaluronate tear substitute without preservatives. RESULTS: A significant decrease of spatial-contrast sensitivity ranging from 35 to 70% was present in keratoconjunctivitis sicca eyes compared with a third group of age-matched normal eyes used as control. The spatial-contrast sensitivity was significantly lower also in the presence of preserved corneal surface. The addition of a tear substitute improved spatial contrast-sensitivity thresholds in all groups. CONCLUSION: Tear-film disease can affect the transfer function of modulation of the ocular surface.

Bacterial load and protein deposits on 15-day versus 1-day disposable hydrophilic contact lenses.

PURPOSE: This study quantified the bacterial load and protein deposits on 1- and 15-day disposable contact lenses after use in normal wearers. METHODS: Sixteen patients were randomly assigned to a 1-day contact lens (1-Day Acuvue) in one eye and to a 15-day contact lens (Acuvue) in the contralateral eye. Only one specified solution was allowed for the care of 15-day lenses. All patients were evaluated every month for 6 months (at times T1, T2, T3, T4, T5, T6). At times T1, T3, and T5, the lenses were removed in a sterile fashion and sent for laboratory quantification of Staphylococcus aureus and Pseudomonas aeruginosa. At T2, T4, and T6, quantification of protein deposits was determined, and at T0 and T6, impression cytology of the conjunctiva was performed. RESULTS: P. aeruginosa was not identified on any lens. At T1, T3, and T5, S. aureus was significantly greater on the 1-day versus 15-day lenses (p < 0.001). In contrast, protein deposits were significantly greater on the 15-day lenses at all time points (T2, T6: p < 0.01; T4: p < 0.05). Impression cytology of the 15-day lens eyes revealed a worsening trend compared to the 1-day lens; however, no statistically significant differences were found between the two groups (p = 0.29). CONCLUSION: Results of this study suggest that the use of cleaning and preservative solutions can alter the ocular surface bacterial environment of the contact lens wearer and that these changes are not a direct consequence of contact lens wear. The bactericidal activity of these solutions could, with time, also affect ocular surface cells, leading to contact lens intolerance and ocular surface disease.

Choroidal hemangioma treated with photodynamic therapy using verteporfin: report of a case.

PURPOSE: To report the results of treatment of circumscribed choroidal hemangioma with a single application of photodynamic therapy (PDT) with verteporfin according to the Treatment of Age-related Macular Degeneration with Photodynamic Therapy study. METHODS: A 44-year-old man with unilateral decreased vision and macular subretinal fluid secondary to a circumscribed choroidal hemangioma diagnosed by fluorescein and indocyanine green angiography and ultrasonography underwent PDT with verteporfin therapy. RESULTS: One year after PDT, subretinal fluid was absent and visual acuity improved. CONCLUSIONS: The results obtained in this case are in keeping with previously reported results; however, future randomized studies are necessary to evaluate and standardize different infusion times in order to obtain maximum efficacy of treatment.

Evaluation of amblyopic scotoma by electrophysiological examinations and computerized perimetry.

To evaluate amblyopic scotoma and the most affected neural cells in suppressive phenomena, eight patients with deep amblyopia from strabismus (visual acuity of the amblyopic eye between 4/50 and 2/10) underwent a pattern electroretinogram (PERG), pattern visual evoked potential (VEP), and event-related potential (ERP) from visual stimuli, and computerized perimetry. The results of stimulation of the amblyopic eye, the leading eye and the leading eye penalized by Ryser filters were compared statistically. Computerized perimetry was used to quantify the depth and amplitude of the amblyopic scotoma. All electrophysiological potentials were reduced in amplitude and the implicit times of VEP and ERP were longer when stimulating the amblyopic eye compared to the leading eye. Only in PERG the penalization induced major changes. Our data suggest that the important suppressive phenomena present in the squint amblyopic eye involve not only the occipital cortex, but also the cognitive areas.

The nasal step in normal and glaucomatous visual fields.

We used an original method of kinetic and static analysis to examine the nasal visual field. When the nasal step is less than 4 degrees wide and its depth is less than 0.5 log units it may be merely a physiological sign of the anatomic and functional asymmetry of the retina. Sometimes it is an artifact. The nasal step can also be a glaucomatous defect. In this case it is often an early sign and it is wider than 4 degrees and its depth is greater than 0.5 log units. Because of its typical shape and invariable location it is easy to discover by kinetic perimetry and easy to check by static perimetry. If it is an early glaucomatous defect, it can be reversed. In practice the nasal step is an early and characteristic glaucomatous field defect like the isolated scotomas in the Bjerrum area, and it is easily detected and can be used as a sensitive marker in the follow up of glaucomatous damage.

Women with a pelvic mass: indicators of malignancy.

OBJECTIVE: To evaluate the efficacy of five methods: pelvic examination (PE), transvaginal ultrasonography (US), Doppler ultrasonography, serum CA125 assay and serum CA72-4 assay, alone or associated, to predict malignancy in patients presenting a pelvic mass originating in the ovary. METHODS: 92 patients underwent a standard protocol for physical examination, CA125, CA72-4, transvaginal ultrasonography and Doppler ultrasonography. RESULTS: Eighteen women were dropped from the study because they had clearly benign masses; two women were dropped from the study because they had clearly malignant lesions. Twenty-two malignant (30%) and 50 benign (70%) pelvic tumors were found. When one method was considered alone the best sensitivity (SENS) was found in physical examination (90%) and the best specificity (SPEC) was found in CA72-4: 88%. If all indicators were positive, the SPEC was 100% but the SENS was 40%. Logistic regression analysis prediction of the character of the pelvic masses was correct in 86%. CONCLUSION: Some additional information to discriminate between malignant and benign pelvic masses can be obtained from the valuation of serum tumor markers, particularly CA72-4. Also Doppler ultrasonography appeared to be useful in the differential diagnosis of pelvic tumors. The prediction of the character of the pelvic masses calculated by a logistic model in which PE, US, CA 125, and CA72-4 are included is very good.