Preoperative predictors that impact the survival and outcome of patients undergoing secondary cytoreduction for ovarian cancer.

This study aimed to examine the factors affecting feasibility of optimal and complete secondary cytoreductive surgery (SCRS) and to characterise the prognostic factors that correlate with improved survival in patients who underwent SCRS. This is a retrospective single-institutional cohort study of patients who underwent SCRS for recurrent epithelial ovarian cancer (EOC). One hundred and forty-eight patients met inclusion criteria. Platinum sensitivity was associated with complete cytoreduction at SCRS. Factors associated with suboptimal cytoreduction (SOC) were age >55 years, serous histology, largest tumour implant size >4 cm, and SOC at primary surgery. Overall survival analysis showed significantly longer survival with complete cytoreduction compared to optimal and SOC. Surgical outcome of SCRS was an independent predictor of survival regardless of the outcome of primary cytoreduction. Location of the largest implant, DFI and timing of chemotherapy also impact on survival.

Colposcopic and cytologic detection of chronic lymphocytic leukemia in the vagina: a case report.

BACKGROUND: Chronic lymphocytic leukemia (CLL) is one of the chronic lymphoproliferative disorders. CLL has a wide range of physical findings at the time of initial discovery, with lymphadenopathy being the most common. We report the first case of primary presentation of CLL of the vaginal cuff in an asymptomatic patient. CASE: A 68-year-old, white woman status post-total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis 25 years earlier, was referred for colposcopic evaluation of low-grade squamous intraepithelial lesion of the vagina. Pathologic examination, immunohistochemical studies, and immunoglobulin gene rearrangement studies of the biopsy specimens were performed. All of these findings were supportive of a diagnosis of CLL. CONCLUSION: CLL in the vagina may present as an asymptomatic lesion. Hematologic malignancies should be considered in the differential diagnosis during workup of abnormal vaginal cytology.

Interaction of the anorectic medication, phendimetrazine, and its metabolites with monoamine transporters in rat brain.

Phendimetrazine is an effective and widely prescribed appetite suppressant. Preclinical findings show that phendimetrazine displays stimulant properties similar to amphetamine, but few studies have examined the neurochemical mechanism of the drug. In the present work, we characterize the activity of phendimetrazine and its putative metabolites [phenmetrazine, pseudophenmetrazine, and associated stereoisomers] at biogenic amine transporters. All drugs were tested in vitro using assays to measure uptake and release of [3H]dopamine, [3H]norepinephrine, and [3H]serotonin ([3H]5-HT) in rat brain synaptosomes. Selected drugs were tested in vivo using microdialysis to measure extracellular dopamine and serotonin (5-HT) in rat nucleus accumbens. Phendimetrazine itself had no effect on uptake or release of any transmitter. In contrast, the trans-configured N-demethylated metabolite, phenmetrazine, was a potent releaser of [3H]norepinephrine (EC(50)=50 nM) and [3H]dopamine (EC(50)=131 nM). The cis N-demethylated metabolite, pseudophenmetrazine, displayed modest potency at releasing [3H]norepinephrine (EC(50)=514 nM) and blocking [3H]dopamine re-uptake (IC(50)=2630 nM). All drugs tested were inactive or weak in the [3H]5-HT assays. When injected intravenously, phendimetrazine had minimal effects on extracellular transmitter levels, whereas phenmetrazine produced dose-related elevations in extracellular dopamine. The collective findings suggest that phendimetrazine is a "prodrug" that is converted to the active metabolite phenmetrazine, a potent substrate for norepinephrine and dopamine transporters.