Episodic formation of cometary material in the outburst of a young Sun-like star.

The Solar System originated in a cloud of interstellar gas and dust. The dust is in the form of amorphous silicate particles and carbonaceous dust. The composition of cometary material, however, shows that a significant fraction of the amorphous silicate dust was transformed into crystalline form during the early evolution of the protosolar nebula. How and when this transformation happened has been a question of debate, with the main options being heating by the young Sun and shock heating. Here we report mid-infrared features in the outburst spectrum of the young Sun-like star EX Lupi that were not present in quiescence. We attribute them to crystalline forsterite. We conclude that the crystals were produced through thermal annealing in the surface layer of the inner disk by heat from the outburst, a process that has hitherto not been considered. The observed lack of cold crystals excludes shock heating at larger radii.

A retrospective study of 27 ovarian tumors of low malignant potential.

INTRODUCTION: This study was undertaken to retrospectively review the fertility-sparing surgical treatment and long-term outcome of 27 patients with ovarian tumors of low malignant potential treated at the 1st Department of Obstetrics and Gynecology of Semmelweis University Faculty of Medicine between 1990 and 2000. MATERIALS AND METHODS: Between 1990 and 2000, 163 patients with epithelial ovarian tumors were diagnosed and treated. Of these, 27 patients were diagnosed as having low malignant potential (LMP) ovarian tumors. The authors evalutated the effect of histopathologic parameters (histologic type, grade of nuclear atypia, tumor size and tumor growth on the ovarian surface) and clinical parameters (age at diagnosis, stage of disease, and treatment modalities) on prognosis in this group of patients with a long observation time. We reviewed our experience to assess the safety of conservative surgical management of patients younger than age 40 with early stage disease, and to determine the long-term outcome of low malignant potential ovarian tumors. Medical records were reviewed on all 27 patients to determine age, gravidity, size of tumor, bilaterality, sites of extraovarian involvement, stage of disease and the operative procedure. Follow-up information was obtained from hospital records, and in some cases, by direct patient contact. Statistical comparisions were made by the chi2 test. RESULTS: The incidence of LMP tumors in our patient population was 16.5%. The patients ranged in age from 15 to 82 years (median, 45 years). The lesions were staged according to FIGO. The stage distribution was Stage IA in 20 patients, Stage IB in one patient, Stage IC in one patient, Stage IIA in one patient, Stage IIB in one patient, Stage IIC in one patient and Stage IIIA in two patients. The ovarian tumors ranged in size from 3 to 19 cm (median 9 cm) and 15% of the tumors were bilateral. All patients with LMP ovarian tumors were treated with primary surgery; those who were older than 40 (14 patients) were treated with total trans-abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO), while patients younger than 40 with early stage disease (12 patients) who wished to retain their fertility potential were treated with fertility-sparing surgery, namely unilateral salpingo-oophorectomy (USO). One patient who was younger than 40 with a Stage IIIA LMP ovarian tumor was also treated with TAH and BSO. Follow-up information was available for all 27 patients with LMP ovarian tumors. Only those patients with a minimum of two years of follow-up were included. Follow-up information from two to ten years (median, 6 years; mean, 6.5 years) revealed that all 27 patients were alive. During the period of follow-up one patient who initially had stage IIIA disease developed recurrent tumor. Fifty percent of patients who underwent conservative fertility-sparing surgical treatment (6/12) subsequently conceived. CONCLUSIONS: This study confirms the excellent prognosis for patients with low malignant potential ovarian tumors. Conservative fertility-saving surgical treatment can be offered to young patients (< 40 years) with early stage (stage I-II) disease who wish to retain their fertility potential. Up to 50% of women in this study who underwent conservative surgery subsequently conceived. The long-term outcome of LMP ovarian tumors is extremely favorable, even when long-term follow-up is extended to ten years.

Adjuvant chemotherapy following surgery in the management of uterine sarcomas.

OBJECTIVE: The aim of this study was to investigate the use of imaging tools in the diagnosis of uterine sarcomas, and to evaluate the effect of the adjuvant chemotherapy for uterine sarcomas. PATIENTS AND METHODS: The data of 29 patients with uterine sarcomas who received cytostatic polychemotherapy between 1990 and 2000 at the Oncological Division of the Ist Department of Obstetrics and Gynecology, Semmelweis University were evaluated by the authors. Symptoms leading to diagnosis and methods of diagnosis were examined. Vascular changes shown by two-dimensional, color and pulsed Doppler ultrasonography were observed. For staging the currently accepted FIGO method was adopted. Most of the patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH & BSO). In each case we administered adjuvant combination chemotherapy according to the CYVADIC-protocol. The effect of adjuvant chemotherapy was evaluated. RESULTS: Six patients had Stage I, ten had Stage II, 11 had Stage III, and two had Stage IV disease. The mean age of the patients was 53.6 years with a range of 22 to 77 years. Histopathologic distribution included nine leiomyosarcomas (LMS), 13 mixed mesodermal sarcomas (MMS), and seven endometrial stromal sarcomas (ESS). Although most patients experienced neutropenia following cytotoxic chemotherapy, other non-hematologic adverse effects were easy to control. The average progression-free interval was 22.14 months, in which no significant difference was found between the histologic types. Different stages showed highly varied responses: surprisingly, patients in Stage IV with lung metastases were documented to have the longest progression-free survival. The three-year survival rate for all stages was demonstrated in 34.4% of cases. Patients with progressive disease had an average survival period of 4.4 months. CONCLUSIONS: These findings suggest that adjuvant cytostatic therapy for patients with distant metastasis confined to a single organ may produce better results than expected.

[Ovarian carcinoma of low malignant potential treated at the 1(st) Department of Obstetrics and Gynecology Semmelweis University Faculty of Medicine, between 1990 and 2000] / Az alacsony malignitású petefészek-daganatok kezelésével szerzett tapasztalataink Klinikánk 10 éves beteganyagában (1990-2000).

The authors analyzed the epidemiologic and histological characteristics and the management of ovarian carcinoma of low malignant potential (LMP) at a university hospital between 1990 and 2000. The authors carried out a retrospective study reviewing hospital charts. Based on the records experience with 29 such tumors is peresented. Of these 20 (74%) were of the serous variety, 7 (26%) were mucinous. LMP tumors accounted for 16% of proliferating epithelial ovarian tumors. They occured at a mean age of 45 years. The LMP tumors were bilateral in 12% of the cases. The majority of patients (87%) with LMP tumors presented with early stage disease. Tumor markers such as CA-125 were not always elevated as in invasive ovarian carcinoma. Laboratory investigations have not demonstrated that these tumors represent an intermediate step between benign ovarian tumors and carcinoma. The recommended therapy is surgical, consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal washings, and tumor debulking. Conservative surgery consisting of unilateral salpingo-oophorectomy is considered to be an appropriate treatment for young women with early stage LMP ovarian tumors who wish to retain their fertility potential. 50 percent of women who underwent conservative surgery subsequently conceived in this study. There were no recurrences in the study group, so the authors conclude that the long term outcome of LMP tumors is extremely favorable.