Management of hydrosalpinx before IVF: a literature review.

Hydrosalpinx has a detrimental effect on the outcome of in vitro fertilization (IVF). Surgical intervention such as salpingectomy or tubal occlusion before IVF improves the outcome of IVF, but these procedures are often contraindicated in women with dense pelvic adhesions. Thus, it is worthwhile to search minimally invasive alternative therapies. The main objective of this review is to assess and compare the value of all the therapeutic options for hydrosalpinx before IVF. The results of the following procedures were compared: the laparoscopic treatments (salpingectomy/proximal tubal occlusion), the hysteroscopic insertion of device achieving tubal occlusion, the tuberous sclerosis and the aspiration of hydrosalpingeal fluid at the time of IVF procedure. Laparoscopic surgical treatment should be considered for all women with hydrosalpinx before IVF. Whenever laparoscopy is not recommended, hysteroscopic insertion of device seems the most effective option for management of hydrosalpinx before IVF.

Skin necrosis due to antiblastics (procedures of prevention and therapy).

Among the toxic effects of antitumor drugs the injury for extravasation occurs too. The kinds of damage which result can achieve dramatic features with serious consequences on the psychophysic activity of patients who once tried other kinds of toxicity following chemotherapy. As the extravasation is caused by way of use and by drug-giving methods, we present this accident: it is necessary to observe rigorous rules of procedure during infusion and, if extravasation occurs, to make use of efficient drugs and physical methods. A recent case of extravasation occurred, at our Gynecological Oncology Service, in a patient who carried out chemotherapy without hospitalization. This case is here proposed and discussed; we think that the rarity of this accident is in our experience, due to the several precautions we observe during the infusion of drug.

Prevention by hypothermic cap of antiblastic induced-alopecia.

Adriamycin, one of most effective antitumor drugs, is characterized by high toxicity. The adriamycin-induced alopecia is frequent (80-97% of patients) and rapidly shows itself (already after first treatment). Such toxic effect, so unpleasant particularly to female patients, was largely prevented in our experience (Gynecological Oncology Service) with the utilization of hypothermic caps. These caps, reducing the drug absorption above the scalp, allows limiting the hair loss. The result obtained (reduction of severe alopecia in 34% of patients) encourage the use of such a method to improve the life quality of patients.

Cervical stump carcinoma therapy.

59 patients with cervical stump cancer were reviewed. A distinction was made between true and coincident cancer. Histological features, therapeutic plan and survival rates are reported. In stage I treatment was mainly surgical, while in more advanced stages radiation therapy was applied. In 22.2% of cases combined surgical-radiation therapy was performed. The absolute 5-year survival for various clinical stages is as follows: stage I, 88.2%; stage II, 53.8%; stage III, 42.8%; stage IV, 0.0%. The overall absolute 5-year survival rate for all stages combined is 60.9%. Individualization of therapy can offer to the patient with cervical stump carcinoma a survival similar to the patient with cervical neoplasm with intact uterus.

Role of diet in endometrial cancer patients.

The hypothesis of a correlation between diet and cancer is widely supported by several epidemiological and experimental studies. Certainly the exact mechanism of this intervention is still unknown; nevertheless in the tests of a carcinogenesis the direct action of some food is recognised, whereas the indirect action of others should occur through modifications of immune and endocrine systems. Many studies conclude that a high intake of fats and animal proteins appeared to be associated with the etiology of some endocrine related neoplasms, such as the cancer of prostate breast endometrium and ovary. We studied the dietary practices and some constitutional parameters of women affected by endometrial cancer and control women. We did not find a significant difference between the two groups related to height. Conversely the daily intake of lipids and particularly of proteins, glucides and calories turned out much higher in the group of patients. Moreover we found a significant difference related to weight; obese women were more numerous in the group of patient. The above results confirm the importance of a right diet in the prevention of this neoplasm.

Todays' stage in differential diagnosis between cervical condyloma and CIN.

Seven colposcopic signs (acetic acid staining--borders--thickness--surface contour--colour--vascular atypias--iodine staining) are examined in differential diagnosis between condyloma and CIN. For a better prognostic and therapeutic approach, we think it is useful to follow a diagnostic path whose main steps are: colposcopy, cytology, microcervicoscopy, histology. With the introduction of sophisticated diagnostic techniques (molecular hybridization--morphology cells study--chromosomes map study) it is possible to determine morphologically the observed lesion and predict, as much as possible, the following evolution.

Neutral and polyanionic carboranylporphyrazines: synthesis and physico-chemical properties.

Among the challenges precluding the widespread use of boron neutron capture therapy (BNCT) has been the difficulty in achieving selective delivery of large quantities of boron to malignant cells. In an attempt to address this issue we have recently developed an effective strategy to synthesize a new family of boronated porphyrazines to be delivered through the membrane of cancerous tissues as such or with the help of liposomes. Herein we describe the synthesis and the basic physico-chemical properties of neutral octa-closo-carboranyl-alkylthio-porphyrazines as well as of their water-soluble counterparts obtained by mild deboronation of the closo-polyedra. Preliminary studies indicate that these compounds show negligible cell toxicity and, compared with BPA, good cellular uptake. This encourages further studies for their evaluation as potential BNCT agents.

Carborane derivatives loaded into liposomes as efficient delivery systems for boron neutron capture therapy.

Boron neutron capture therapy (BNCT) is an anticancer therapy based on the incorporation of (10)B in tumors, followed by neutron irradiation. Recently, the synthesis and delivery of new boronated compounds have been recognized as some of the main challenges in BNCT application. Here, we report on the use of liposomes as carriers for BNCT active compounds. Two carborane derivatives, i.e., o-closocarboranyl beta-lactoside (LCOB) and 1-methyl-o-closocarboranyl-2-hexylthioporphyrazine (H(2)PzCOB), were loaded into liposomes bearing different surface charges. The efficacy of these formulations was tested on model cell cultures, that is, DHD/K12/TRb rat colon carcinoma and B16-F10 murine melanoma. These induce liver and lung metastases, respectively, and are used to study the uptake of standard BNCT drugs, including borophenylalanine (BPA). Boron concentration in treated cells was measured by alpha spectrometry at the TRIGA mark II reactor (University of Pavia). Results showed high performance of the proposed formulations. In particular, the use of cationic liposomes increased the cellular concentration of (10)B by at least 30 times more than that achieved by BPA.