Early preantral follicles of the domestic cat express gonadotropin and sex steroid signaling potential.

Key biomolecular processes, which regulate primordial ovarian follicle dormancy and early folliculogenesis in mammalian ovaries, are not fully understood. The domestic cat is a useful model to study ovarian folliculogenesis and is the most relevant for developing in vitro growth methods to be implemented in wild felid conservation breeding programs. Previously, RNA-sequencing of primordial (PrF), primary (PF), and secondary follicle (SF) samples from domestic cat implicated ovarian steroidogenesis and steroid reception during follicle development. Here, we aimed to identify which sex steroid biosynthesis and metabolism enzymes, gonadotropin receptors, and sex steroid receptors are present and may be potential regulators. Differential gene expression, functional annotation, and enrichment analyses were employed and protein localization was studied too. Gene transcripts for PGR, PGRMC1, AR (steroid receptors), CYP11A1, CYP17A1, HSD17B1 and HSD17B17 (steroidogenic enzymes), and STS (steroid metabolizing enzyme) were significantly differentially expressed (Q values of ≤0.05). Differential gene expression increased in all transcripts during follicle transitions apart from AR which decreased by the secondary stage. Immunohistochemistry localized FSHR and LHCGR to oocytes at each stage. PGRMC1 immunostaining was strongest in granulosa cells, whereas AR was strongest in oocytes throughout each stage. Protein signals for steroidogenic enzymes were only detectable in SFs. Products of these significantly differentially expressed genes may regulate domestic cat preantral folliculogenesis. In vitro growth could be optimized as all early follicles express gonadotropin and steroid receptors meaning hormone interaction and response may be possible. Protein expression analyses of early SFs supported its potential for producing sex steroids.

The NICE classification for 'Ultra-radical (extensive) surgery for advanced ovarian cancer' guidance does not meaningfully predict postoperative complications: a cohort study.

OBJECTIVE: To determine which descriptors of cytoreductive surgical extent in advanced ovarian cancer (AOC) best predict postoperative morbidity. DESIGN: Retrospective notes review. SETTING: A gynaecological cancer centre in the UK. POPULATION: Six hundred and eight women operated on for AOC over a period of 114 months at a tertiary cancer centre, between 16 August 2007 and 16 February 2017. METHODS: Outcome data were analysed by six approaches to classify the extent of surgery: standard/ultra-radical surgery; standard/radical/supra-radical surgery; presence/absence of gastrointestinal resections; low/intermediate/high surgical complexity score (SCS); presence of bowel anastomoses and/or diaphragmatic surgery; and the presence/absence of multiple bowel resections. MAIN OUTCOME MEASURES: Major (grades 3-5) postoperative morbidity and mortality. RESULTS: Forty-three (7.1%) patients experienced major complications. Grade-5 complications occurred in six patients (1.0%). Patients who underwent multiple bowel resections had a relative risk (RR) of 7.73 (95% confidence interval, 95% CI 3.92-15.26), patients with a high SCS had an RR of 6.12 (95% CI 3.25-11.52), patients with diaphragmatic surgery and gastrointestinal anastomosis had an RR of 5.57 (95% CI 2.65-11.72), patients with 'any gastrointestinal resection' had an RR of 4.69 (95% CI 2.66-8.24), patients with ultra-radical surgery had an RR of 4.65 (95% CI 2.26-8.79), and patients with supra-radical surgery had an RR of 4.20 (95% CI 2.35-7.51) of grades 3-5 morbidity, compared with patients undergoing standard surgery as defined by the National Institute for Health and Care Excellence (NICE) in the UK. No significant difference was seen in the rate of major morbidity between standard (6/59, 10.2%) and ultra-radical (9/81, 11.1%) surgery within the cohort who had intermediate complex surgery (P > 0.05). CONCLUSIONS: The numbers of procedures performed significantly correlate with major morbidity. The number of procedures performed better predicted major postoperative morbidity than the performance of certain 'high risk' procedures. We recommend using SCS to define a higher risk operation. NICE should re-evaluate the use of the term 'ultra-radical' surgery. TWEETABLE ABSTRACT: Multiple bowel resection is the best predictor of morbidity and is more predictive than 'ultra-radical surgery'.

Effects of corn silage inclusion in preweaning calf diets.

The objective of this research was to evaluate the effects of corn silage inclusion in starter feed provided to calves after birth through weaning at 7 wk of age. Thirty-six heifer calves and 9 bull calves were individually housed in hutches. Calves in treatment groups received pasteurized milk with all calf starter, 25% calf starter and 75% corn silage, or all corn silage. Values were recorded daily for feed intake and health, which included fecal, respiratory, and attitude scores; and at wk 2, 4, and 8 for concentrations of serum protein, hematocrit, and serum ß-hydroxybutyrate. Body weight, withers height, and hip height were measured at wk 2, 4, 8, and 52. Nine bull calves (3/treatment) were killed at 8 wk of age for assessment of rumen and intestinal tissue morphology. Feed intake and average daily gain were not different among treatments. Least squares means of rumen papillae lengths were significantly different and decreased as corn silage inclusion increased. Crypt depths and total thickness of epithelium were reduced for the corn silage group. Least squares means of body weight, heart girth, hip height, withers height, serum protein, hematocrit, and ß-hydroxybutyrate concentrations did not differ among treatments. These data indicated that the mixture of corn silage and starter did not affect growth, feed intake, or intestinal morphology but did affect rumen wall morphology. Feeding solely corn silage as starter feed stunted the growth of rumen papillae and tended to impair intestinal morphology, indicating that only calf starter or a mixture of calf starter and corn silage is more appropriate.

Adjacent Lichen Sclerosis predicts local recurrence and second field tumour in women with vulvar squamous cell carcinoma.

OBJECTIVE: In this study, we investigated if the presence of histologically abnormal epithelium adjacent to the primary tumour influenced the frequency, timing, and topography of local vulvar recurrences (LVR) following treatment for squamous cell carcinoma of the vulva (VSCC). METHODS: The study population comprised a cohort of 201 consecutive cases with incident VSCC. LVR were categorised as local relapses (LR) if they occurred <2cm from the tumour margins, and as second field tumours (SFT) when ≥2cm from these margins. Univariable and multivariable competing risk modelling was performed to identify the prognostic factors associated with local disease recurrence. RESULTS: The characterization of the epithelium adjacent to the invasive component was possible for 199 (99.0%) patients. Of these, 171 (85.9%) were found to have intraepithelial abnormalities found adjacent to the surgical specimen. Multivariable analyses revealed that, following adjustment, Lichen Sclerosis (LS) was associated with an increase in the incidence of LVR, LR and SFT (SHRs: 3.4, 2.7 and 4.4, respectively). Although the incidence of LR and SFT in women with LS associated VSCC was similar, the peak incidence of SFT occurred more than two years before that of LR. CONCLUSIONS: Women with VSCC arising in a field of LS may continue to have an increased risk of developing LR and SFT for many years after resection of their primary tumour. Our study suggests that these women should be followed up more regularly so that LVR can be detected earlier; unless a more robust surveillance programme or chemopreventative treatments become available.

Should pelvic exenteration for symptomatic relief in gynaecology malignancies be offered?

OBJECTIVE: To review the outcomes of pelvic exenterative surgery done with a palliative intent and evaluate its role in relapsed gynaecology malignancies. METHOD: This is a retrospective cohort study between April 2009 and May 2012 in Oxford Gynaecological Cancer Centre. Patients were identified from the oncology surgical database. RESULTS: 18 patients were identified with a mean age 54 (26-79) years, who underwent surgery for symptomatic recurrent cancer. All except one patient had radiotherapy prior to surgery. 12 patients had cervical cancer, five had vulval cancer and one had endometrial cancer. About half of the patients had major surgical complications; however, majority was patients satisfied with the outcome. CONCLUSION: Pelvic exenteration in this context carries considerable morbidity and in this series achieved good symptom control with a mean overall survival of 11 months. Careful patient selection, adequate counselling and ongoing support are imperative of successful outcome.

Composition-property relationships for an experimental composite nerve guidance conduit: evaluating cytotoxicity and initial tensile strength.

The objective of this work was to examine the main (individual), combined (interaction) and second-order (quadratic) effects of: (i) poly(D,L-lactide-co-glycolide) (PLGA), (ii) F127, and (iii) a zinc-silicate based bioactive glass, on the cytotoxicity and ultimate tensile strength of an experimental nerve guidance conduit (NGC). The experimental plan was carried out according to a Box-Behnken design matrix. The effects of each compositional factor were quantified using response surface methodology (RSM) techniques. Linear and quadratic polynomial equations were developed to examine cytotoxicity (after incubation at 3, 7 and 28 days) and initial ultimate tensile strength (UTS(0)). Multiple regression analyses showed that the developed models yielded a good prediction for each response examined. It was observed that the beneficial effects of PLGA and bioactive glass on controlling cytotoxicity appeared greater than that of F127. Furthermore, the experimental conduits (with the exception of CNGC-I and CNGC-K) generally showed superior cytocompatibility when compared with the comparable literature for the clinically used nerve guidance conduit Neurolac(®). In this investigation, optimal compositions for cell viability were obtained for the following composition: PLGA = 18.89 wt%/F127 = 0.52 wt%/glass = 12.71 wt%. The optimization of composition with respect to ultimate tensile strength was also established (desired UTS(0) being based on the properties of the control device Neurolac(®) whose UTS is c.20 MPa). The desired UTS(0) of ≤ 20 MPa was found for the composition: PLGA = 18.63 wt%/F127 = 0.77 wt%/glass = 5.54 wt%. A UTS(0) ≤ 30 MPa was recorded for the composition: PLGA = 18.34 wt%/F127 = 0.62 wt%/glass = 9.83 wt%, such tensile strengths are comparable to, reported values for Neurolac(®). Examination of the composition-property relationships with respect to combining cell viability and UTS(0) indicated preferred compositions in the range 17.97-19.90 wt% PLGA, 0.16-1.13 wt% F127 and between 5.54 and ≤ 20 wt% glass. This research demonstrates the value of a design of experiments approach for the design of novel nerve guidance conduits, and shows that the materials examined may have potential for the repair of peripheral nerve discontinuities.

Bacterial delivery of a novel cytolysin to hypoxic areas of solid tumors.

The efficacy of current anti-cancer gene therapies is limited by the inability of gene vectors to penetrate the poorly vascularized, hypoxic regions of tumors, leaving these sites untreated. We describe a new approach for targeting gene therapy to these sites, which employs an attenuated strain of the non-pathogenic bacterium, Salmonella typhimurium, carrying an exogenous (that is, reporter or therapeutic) gene under the regulation of a new, highly hypoxia-inducible promoter (FF+20(*)). This bacterial vector was seen to rapidly migrate into, and thrive in, hypoxic areas of both mammary tumor spheroids grown in vitro and orthotopic mammary tumors after systemic injection. Using the reporter gene construct, FF+20(*)-lacZ, we show that bacterial expression of high levels of beta-galactosidase occurred only in hypoxic/necrotic sites of spheroids and tumors. We then replaced the reporter gene with one encoding a novel cytotoxic protein (HlyE) and showed that this was also expressed by bacteria only in hypoxic regions of murine mammary tumors. This resulted in a marked increase in tumor necrosis and reduced tumor growth. Our system represents a promising new strategy for delivering gene therapy to poorly vascularized regions of tumors and shows, for the first time, the efficacy of HlyE as an anti-tumor agent.

Identifying symptoms of ovarian cancer: a qualitative and quantitative study.

INTRODUCTION: Symptoms of ovarian cancer are often vague and consequently a high proportion of women with ovarian cancer are not referred to the appropriate clinic. OBJECTIVE: To identify diagnostic factors for ovarian cancer. DESIGN: A qualitative and quantitative study. SETTING: Four UK hospitals. SAMPLE: One hundred and twenty-four women referred to hospital with suspected ovarian malignancy. METHODS: Women were interviewed prior to diagnosis (n = 63), or soon after. A thematic analysis was conducted. Emergent symptoms were quantitatively analysed to identify distinguishing features of ovarian cancer. MAIN OUTCOMES: Symptoms in women with and without ovarian cancer. RESULTS: Diagnoses comprised 44 malignancies, 59 benign gynaecological pathologies and 21 normal findings. Of the malignancies, 25 women had stage III or more disease, with an average age of 59 years. The benign/normal cohort was significantly younger (48 years). Multivariate analysis revealed persistent abdominal distension (OR 5.2, 95% CI 1.3-20.5), postmenopausal bleeding (OR 9.2, 95% CI 1.1-76.1), appetite loss (OR 3.2, 95% CI 1.1-9.2), early satiety (OR 5.0, 95% CI 1.6-15.7) and progressive symptoms (OR 3.6, 95% CI 1.3-9.8) as independent, statistically significant variables associated with ovarian cancer. Fluctuating distension was not associated with ovarian cancer (OR 0.4, 95% CI 0-4.1). Women frequently used the term bloating, but this represented two distinct events: persistent abdominal distension and fluctuating distension/discomfort. CONCLUSIONS: Ovarian cancer is not a silent killer. Clinicians should distinguish between persistent and fluctuating distension. Recognition of the significance of symptoms described by women could lead to earlier and more appropriate referral.

Cystic struma ovarii presenting as pseudo-Meigs' syndrome with elevated CA125 levels. A case report and review of the literature.

Struma ovarii is a rare ovarian teratoma consisted predominantly of mature thyroid tissue. Although the vast majority of strumas are benign, they can present mimicking malignancy. We report a case of a postmenopausal woman who presented with a large pelvic mass, ascites, and high CA125 levels. Further investigation confirmed the existence of bilateral pleural effusions. The patient underwent laparotomy, and histology revealed a benign struma ovarii. Twelve months after the removal of the tumor, the patient remained disease free, with no clinical or radiologic evidence of effusion, and normal CA125 levels. This is only the fifth case in the English literature of a benign struma ovarii presenting as pseudo-Meigs' syndrome with elevated CA125. Struma ovarii should be included in the differential diagnosis of a pelvic mass that presents with ascites, hydrothorax, and elevated tumor markers.

Effects of nucleotide supplementation in milk replacer on small intestinal absorptive capacity in dairy calves.

Milk replacer was supplemented with nucleotides and fed to dairy calves from birth through weaning to examine the potential for enhancing recovery of small intestinal function after enteric infection. Three treatments of 23 calves each were fed milk replacer (10% body weight/d) supplemented with no nucleotides (C), purified nucleotides (N), or nucleotides from an extract of Saccharomyces cerevisiae (S). Average daily gain, health scores, fecal dry matter, and fecal bacteria were monitored, and blood was analyzed for packed cell volume, glucose, blood urea nitrogen (BUN), and creatinine. Calves were monitored twice daily for fecal score, and 48 h after increased fecal fluidity was recorded, intestinal function was evaluated by measuring absorption of orally administered xylose (0.5 g/kg of body weight). Packed cell volume of blood was greater for treatment N for wk 2 and 5 compared with other treatment groups. Four calves per treatment were killed, and intestinal tissue was evaluated for morphology, enzyme activities, and nucleoside transporter mRNA expression. Treatment S calves had increased abundance of nucleoside transporter mRNA, numerically longer villi, and lower alkaline phosphatase than other groups. Growth measurements and plasma concentrations of glucose, BUN, creatinine, and IgG were not different between treatments; however, BUN-to-creatinine ratio was higher for treatment N, possibly indicating decreased kidney function. There were also no treatment effects on fecal dry matter and fecal bacteria population. However, N-treated calves had the highest detrimental and lowest beneficial bacteria overall, indicating an unfavorable intestinal environment. Supplementation of purified nucleotides did not improve intestinal morphology or function and resulted in higher fecal water loss and calf dehydration. Supplementation of nucleotides derived from yeast tended to increase calf intestinal function, provide a more beneficial intestinal environment, and improve intestinal morphology.

A survey of bacteriological quality and the occurrence of Salmonella in raw bovine colostrum.

In recent years, bovine colostrum has gained popularity as a human food because it is an excellent source of bioactive proteins, which have been claimed to inhibit viral and bacterial pathogens, improve gastrointestinal health, and enhance body condition. A study was conducted to determine bacteriological quality and occurrence of Salmonella in colostrum collected from dairy herds (n = 55) in Pennsylvania. Colostrum samples were analyzed for standard plate count, preliminary incubation count, laboratory pasteurization count, Staphylococcus aureus, Streptococcus agalactiae, coagulase negative staphylococci, streptococci, coliforms, and non-coliforms. A standardized polymerase chain reaction assay was used for detection of Salmonella in colostrum. Salmonella were detected in 8 of 55 (15%) of colostrum samples. Streptococcus agalactiae (1000 colony-forming units [CFU]/mL) was detected in one colostrum sample. The mean standard plate count (977,539 CFU/mL), preliminary incubation count (12,094,755 CFU/mL), laboratory pasteurization count (615 CFU/mL), Staphylococcus aureus (306 CFU/mL), coagulase negative staphylococci (164,963 CFU/mL), streptococci (256,722 CFU/mL), coliforms (323,372 CFU/mL), and non-coliforms (111,544 CFU/mL) counts in colostrum were considerably higher than raw bulk tank milk counts reported previously from Pennsylvania. Analysis revealed that farm size did not influence the bacteriological quality of colostrum. Collection, handling, and storage of colostrum need to be addressed to improve bacteriological quality of colostrum intended not only for feeding calves but also for human consumption.

The management of ovarian carcinoma.

Interest in the management of ovarian cancer is still high and research headed to improve survival rates, particularly in case of advanced disease. The outcomes of screening and its potential effects in stage shift and impact on mortality is of great importance. The actual timing of primary radical surgery in advanced disease has been addressed in two large studies, which essentially also investigate the role of neoadjuvant chemotherapy. This may open a new approach to therapy, but the outcomes of these studies should still provide the evidence to support this approach. The same case can be made in relation to managing relapsed disease. Without doubt, the future interventions in women with ovarian cancer, in terms of surgery and chemotherapeutic approaches, will evolve in a more accurate individualisation of therapy, so that, some account of the tumour biology is inherent within the decisions as to the optimum treatments.

Endometrial atypical hyperplasia and subsequent diagnosis of endometrial cancer: a retrospective audit and literature review.

This study investigates the rate of endometrial carcinoma found at hysterectomy in women with a biopsy diagnosis of atypical endometrial hyperplasia, in the John Radcliffe Hospital, Oxford. The Gynecologic Oncology Group (GOG) recently reported a rate of 42.6% in a large prospective study in the USA (Trimble et al. 2006). This retrospective study has identified a similar rate of 45.9% at the John Radcliffe. There is much interest in conservative therapies for atypical endometrial hyperplasia, but with such a high incidence of endometrial carcinoma in cases of atypical endometrial hyperplasia diagnosed by endometrial biopsy, it would seem prudent to exercise caution when considering any conservative therapy.

Management of minor cervical cytological abnormalities: a systematic review and a meta-analysis of the literature.

BACKGROUND: A significant number of women are diagnosed with a low grade cytological abnormality on cervical screening. Many authorities recommend surveillance as spontaneous regression might occur. However, protracted attendance for cytological follow-up decreases with time and might put some women at risk of developing invasive disease. The aim of this review was to assess management options for women with minor cervical disease. METHODS: An electronic literature search was conducted. All randomised controlled studies comparing immediate colposcopy to cytological surveillance in women with cervical atypia/borderline nuclear changes or low-grade lesions were included. The main outcomes studied were the default rates from the colposcopy clinic and the histological status of biopsies within immediate management protocols compared to biopsies taken on completion of surveillance. Pooled relative risks and 95% confidence intervals were calculated using a random-effect model and inter-study heterogeneity was assessed with Cochrane's Q-test. RESULTS: Three randomised controlled trials identified from the literature search with different surveillance periods were combined. The analysis revealed that compliance with follow-up declines over time and reaches significance at the end of 24 months of surveillance (RR: 74.10 [10.36, 529.79]). There was a significantly higher incidence of HPV and CIN 1 in those women referred to immediate colposcopy/treatment compared to those at the end of 24 months surveillance period (32% vs 21%) (RR 1.49, 95% CI 1.17-1.90) and (21% vs 8%) (RR 2.58, 95% CI 1.69-3.94), respectively, possibly explained by spontaneous regression of clinically non-important lesions. Finally, there was no significant difference in the incidence of CIN2 or worse at initial colposcopy compared with the observation group (24 months) (RR 1.72, 95% CI 0.85-3.48). CONCLUSION: Cytological surveillance puts women at risk as many show poor compliance and such women might have occult high grade abnormalities. A general policy should be immediate colposcopy for all women after a single low grade cervical smear.

Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer.

BACKGROUND: Epithelial ovarian cancer presents at an advanced stage in the majority of patients. These women require chemotherapy and surgery for optimal treatment. Conventional treatment is to perform surgery first and then give chemotherapy. However, it is important to determine whether there is any advantage to using chemotherapy prior to surgery. OBJECTIVES: To assess whether there is an advantage to treating women with advanced epithelial ovarian cancer with chemotherapy prior to debulking surgery (neoadjuvant chemotherapy) compared with conventional treatment where chemotherapy follows maximal debulking surgery. SEARCH STRATEGY: RCTs were identified by searching The Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, 2006), MEDLINE (Silver Platter, from 1966 to 1st Sept 2006), EMBASE via Ovid (from 1980 to 1st Sept 2006), CANCERLIT (from 1966 to 1st Sept 2006), PDQ (search for open and closed trials) and MetaRegister (most current search Sept 2006). SELECTION CRITERIA: Women with advanced epithelial ovarian cancer (Federation of International Gynaecologists and Obstetricians (FIGO) stage III-IV); randomized allocation to treatment groups which compared platinum-based chemotherapy before debulking surgery with platinum-based chemotherapy following debulking surgery. DATA COLLECTION AND ANALYSIS: Data were extracted by three independent authors, and the quality of included trials was assessed by three independent authors. MAIN RESULTS: One RCT was identified as meeting the inclusion criteria. This trial randomized 85 women and compared standard debulking surgery followed by eight cycles of platinum-based chemotherapy with pre-operative intra-arterial platinum-based chemotherapy and ovarian artery embolization followed by debulking surgery and seven cycles of platinum-based chemotherapy. There was no statistical difference in median overall survival (OS) between the two treatment groups. Three on-going RCTs were identified and their results are awaited. AUTHORS' CONCLUSIONS: There is as yet no good evidence that neoadjuvant chemotherapy prior to debulking surgery for women with advanced epithelial ovarian cancer is superior to conventional debulking surgery and platinum-based chemotherapy.

A survey of bovine colostrum composition and colostrum management practices on Pennsylvania dairy farms.

Colostrum composition and management were surveyed via sample and data collection from 55 dairy farms in Pennsylvania. Colostrum samples were analyzed for fat, protein, lactose, total solids, ash, Ig, lactoferrin, water- and fat-soluble vitamins, and minerals. Mean percentages of fat, protein, and lactose in colostrum were 6.7, 14.9, and 2.5, respectively. Concentrations of IgG1, IgG2, IgA, IgM, and lactoferrin were 35.0, 6.0, 1.7, 4.3, and 0.8 mg/mL, respectively. Mean concentrations of fat-soluble vitamins, including retinol, tocopherol, and beta-carotene, were 4.9, 2.9, and 0.7 microg/g, respectively. Mean concentrations of water-soluble vitamins were 0.34, 0.90, 4.55, 0.60, 0.15, 0.21, and 0.04 microg/mL for niacin, thiamine, riboflavin, vitamin B12, pyridoxal, pyridoxamine, and pyridoxine, respectively. Mean concentrations (mg/kg) of selected minerals in colostrum were also determined (Ca 4,716; P 4,452; Mg 733; Na 1,058; K 2,845; Zn 38; Fe 5.3; Cu 0.3; S 2,595; and Mn 0.1). The findings of this study revealed that the mean concentrations of most nutrients in colostrum have increased when compared with values previously reported. Results also showed that management practices have improved over time, particularly with regard to colostrum storage and feeding. Additionally, we observed that herd size influenced colostrum management and quality. It can be inferred, based on these findings, that although improvements have been made with regard to colostrum management and quality, there is still a need to educate producers on issues related to storage and timely feeding of colostrum to increase passive transfer and decrease the rate of calf morbidity and mortality.

Key clinical trials in gynaecological oncology.

AIMS: To review the most important clinical trials which have impacted the management of gynaecological cancers, in conjunction with some ongoing studies of interest. METHODS: PubMed and Cochrane databases were searched to find clinical trials and meta-analyses in vulva, cervical, endometrial and ovarian cancers. Other pertinent literature was also used. RESULTS: The majority of trials related to ovarian and cervical cancers, and the least associated with vulval cancer. CONCLUSIONS: To ensure evidence based medicine, trials in gynaecological cancers must be supported. Notably, surgical trials are on the increase in the last decade, but are still a minority when compared with non-surgical interventions.

Solar and photocatalytic disinfection of protozoan, fungal and bacterial microbes in drinking water.

The ability of solar disinfection (SODIS) and solar photocatalytic (TiO(2)) disinfection (SPC-DIS) batch-process reactors to inactivate waterborne protozoan, fungal and bacterial microbes was evaluated. After 8 h simulated solar exposure (870 W/m(2) in the 300 nm-10 microm range, 200 W/m(2) in the 300-400 nm UV range), both SPC-DIS and SODIS achieved at least a 4 log unit reduction in viability against protozoa (the trophozoite stage of Acanthamoeba polyphaga), fungi (Candida albicans, Fusarium solani) and bacteria (Pseudomonas aeruginosa, Escherichia coli). A reduction of only 1.7 log units was recorded for spores of Bacillus subtilis. Both SODIS and SPC-DIS were ineffective against the cyst stage of A. polyphaga.

Cell-mediated-immunity and immunotherapy in ovarian-cancer (review).

The natural containment of ovarian cancer to the peritoneal cavity makes this mileau attractive for examining the immune status within a 'malignant environment'. Such investigations have yielded further insight into host-tumor responses. Immunological strategies have been employed in ovarian cancer either as single agents or combined with chemotherapy and although achieving responses have limited success. The understanding of cytokine inter-relationships, refinement of monoclonal antibody therapy and the potential genetic manipulation will enhance immunological strategies. This review will address aspects of our present knowledge of immune status in ovarian cancer, examine clinical studies incorporating immune agents and potential future therapies.