Uptake of a cholesterol-rich emulsion by neoplastic ovarian tissues.

OBJECTIVE: Previously, it was shown that a lipidic emulsion (LDE) composed of phospholipids and cholesterol esters which binds to low-density lipoprotein (LDL) receptors may concentrate in acute myeloid leukemia cells. In this study, we aimed to verify whether LDE also has the ability to concentrate in malignant ovarian cancer after being injected into the blood circulation of the patients. METHODS: Three groups of women scheduled for surgery were included in the survey: 13 bearing malignant tumors, 9 with benign ovarian tumors, and 13 without ovarian tumor who were scheduled to undergo oophorectomy due to malignant disease of the uterine cervix or endometrium. On the day prior to surgery they were injected with LDE labeled with [(14)C]cholesteryl oleate. Specimens of tumors and normal ovaries excised during surgery were lipid extracted and analyzed for radioactivity counting. Results were expressed in radioactive count (cpm) per gram of tissue. RESULTS: The mean of the uptakes of the emulsion radioactivity by the malignant tumors was roughly eightfold greater when compared with that of the contralateral normal ovaries (2261 +/- 1444 and 275 +/- 137 cpm/g, respectively, P < 0.012), benign tumors, and normal ovaries of the patients without ovarian tumors. CONCLUSION: LDE has the ability to concentrate in malignant ovarian tumor tissue. Therefore, it can be used as a vehicle to direct cytotoxic drugs against malignant ovarian tumors, thus diminishing the side effects of chemotherapy.

Wertheim-Meigs radical hysterectomy.

Wertheim-Meigs hysterectomy is the treatment of choice for invasive cervix cancer stage IB and IIA at the University of São Paulo Medical School. It was performed in 168 patients between 1974 and 1993. Pelvic lymph node metastases were found in 19 patients (11.3%) and 149 were negative lymph node. The recurrence rate was 21% in the positive lymph node and 6% in the negative lymph node patients. Complications occurred in 35 patients (20.83%) and were as follows: atonic bladder in 9.52%; fistulae in 5.59%; urinary incontinence in 4.76%; ureteral stenosis in 2.97%; dehiscence in 2.38% and lymphedema in 1.19%. Intraoperative complications occurred at a rate of 4.76% and involved injuries to the bladder, ureter and great vessels.

Do estrogens improve bone mass in osteoporotic women over ten years of menopause.

A retrospective analysis of 24 patients with established osteoporosis and with ten or more years of menopause treated with conjugated estrogen, progesterone and calcium followed for one year has been performed. Treated women received 0.625 mg/day of conjugated estrogen from day 1 to 25, 5 mg/day of medroxiprogesterone from day 13 to 25, of each cycle, plus calcium (500-1000 mg/day), during one year (12 cycles). As control group was used 18 age-matched that received only calcium (500 a 1000 mg/day). All patients had at least two dual-photon spine and proximal femur (neck, Ward's triangle and trocanter) densities measurements performed 12 months apart. Estrogen treatment was associated with increased bone mineral density at spine and trocanter. Control group did not present any statistically change after one year in any site studied. We concluded that women with ten or more years of menopause and established osteoporosis treated with replacement hormonal therapy and calcium results in improvement of bone mineral density. These data support that women with ten or more years of menopause respond to estrogen replacement therapy with absolute increments in bone density similar to those seen in younger women, in the early menopause.

Treatment of carcinoma in situ of the cervix experience at the Faculty of Medicine, University of São Paulo.

The authors studied a total of 334 cases of carcinoma in situ of the cervix (1975-1990). The patients were 19 to 61 years old (mean age, 36.6 years). The following procedures were performed: cervical amputation in 54.5% of cases, cervical enlarged amputation with resection of the adjacent vaginal mucosa in 23.3%, abdominal hysterectomy in 15.3%, electrocauterization in 3.6%, simple conization in 2.4%, and vaginal hysterectomy in 0.9%. Recurrence rates were: 9.8% after cervical amputation, 1.3% after cervical enlarged amputation, 25% after simple conization, 5.8% after abdominal hysterectomy, and 33% after electrocauterization. Recurrences were detected before the 18th month after treatment and none of them was of the invasive type. The treatment procedure with the highest rate of complications was cervical enlarged amputation (16%), followed by simple conization (12%), total abdominal hysterectomy (3.9%), and cervical amputation (2.9%). The authors conclude that, although cervical enlarged amputation was followed by the lowest recurrence rate, it was also the treatment followed by the largest number of complications. On this basis, they recommend cervical amputation or hysterectomy. For young women who wish to have children, simple conization is recommended.

Hemangiopericitoma da vulva. / Hemangiopericytoma of the vulva

Apresentamos um caso de hemangiopericitoma vulvar. Tal tipo de tumor nao foi ainda descrito nesta localizacao e clinicamente apresentou-se como um tumor solido de glandula de Bartholin, em mulher de 45 anos. O diagnostico so foi possivel apos o exame anatomo-patologico da neoplasia retirada cirurgicamente

Correlacao entre incidencia de tumores do ovario e grupo sanguineo. / Correlation between the incidence of tumors of the ovary and blood group

Os autores estudaram 92 casos de tumores malignos do ovario registrados na Clinica Ginecoligica da Faculdade de Medicina da Universidade de Sao Paulo entre 1960 a 1981. Analisaram o grupo sanguineo de tais doentes e compararam os resultados com grupo controle de 2.100 mulheres sadias.Entre as mulheres portadoras de tumor particularizaram o estudo para aquelas com carcinoma papiliferos. Demonstraram que, entre as portadoras de carcinomas papiliferos, o grupo sanguineo A foi 1,382 mais frequentemente encontrado que o grupo O.Igualmente, ocorreu frequencia 1,269 vezes maior do grupo A que todos os outros grupos entre aquelas pacientes. Por outro lado, demonstrou-se que pacientes de todos os outros grupos sanguineos, exceto o O, sao 1,378 vezes mais encontradicas entre as doentes com cancer papilifero. Tais dados sugeririam maior predisposicao de mulheres do grupo sanguineo A em adquirir a molestia assim como uma protecao a doenca relativamente ao grupo O. Cuidadosos estudos estatisticos efetuados, no entanto, nao demonstraram serem tais numeros significativos. Nao obstante, devido a importancia em se reconhecer mulheres de alto risco para cancer de ovario, os autores sugerem que prossigam os estudos,com maior numero de casos, com o objetivo de verificar o real significado da associacao grupo sanguineo com cancer de ovario