Lysophospholipids increase interleukin-8 expression in ovarian cancer cells.

OBJECTIVES: We have previously described that bioactive lysophospholipids-lysophosphatidic acid (LPA), sphingosine 1-phosphate (S1P), and sphingosylphosphorylcholine (SPC)-are present in ascitic fluids from patients with ovarian cancer. To understand the role of these lipids in ovarian cancer, we investigated the effects of these lipids on interleukin-8 (IL-8) production in ovarian cancer cells. IL-8 is a proinflammatory and proangiogenic factor, which is potentially involved in ovarian cancer development. METHODS: The Clontech PCR-Select cDNA subtraction method (Clontech Laboratories, Inc., Palo Alto, CA) was used to identify genes potentially regulated by LPA in HEY and OCC1 ovarian cancer cell lines. Northern blot analysis was used to confirm and examine IL-8 mRNA regulation by lysolipids. Enzyme-linked immunosorbent assay (ELISA) was used for detecting secreted IL-8. RESULTS: We describe here that LPA, S1P, and SPC increased mRNA levels (2- to 7-fold) and protein secretion (2- to 12-fold) of IL-8 from ovarian cancer cells (HEY, OCC1, and SKOV3) in vitro. These regulations were both dose- and time-dependent. All three lipids increased the stability IL-8 mRNA in HEY cells. In contrast to malignant ovarian cancer cells, immortalized human ovarian epithelial cells did not respond to any of these lipids to increase the secretion of IL-8, although these cells secreted similar basal levels of IL-8 (310 pg/ml/10,000 cells). Two breast cancer cell lines (MCF7 and T47D) secreted lower basal levels of IL-8 (48-80 pg/ml/10,000 cells), compared with ovarian cancer cells (200-500 pg/ml/10,000 cells). MCF7 cells responded to LPA, but not S1P and SPC, by increasing the secretion of IL-8. T47D and MCF10A, an immortalized breast cell line, did not respond to LPA, S1P, or SPC to increase IL-8 secretion. CONCLUSIONS: LPA, S1P, and SPC regulate the mRNA and protein levels of the proinflammatory and proangiogenic factor IL-8 in ovarian cancer cells. The pathological significance of these regulations in ovarian cancer remains to be further investigated.

The role and clinical applications of bioactive lysolipids in ovarian cancer.

OBJECTIVE: To review the current understanding of the role of bioactive lysolipids in ovarian cancer and their potential clinical applications. METHODS: A MEDLINE search and our own work, including some unpublished work, are the major sources of the review. The MEDLINE search terms used included lysophosphatidic acid, lysophophatidylcholine (LPC), lysophosphatidylinositol (LPI), sphingosine-1-phosphate, and sphingosylphosphorylcholine (SPC). RESULTS: Elevated lysolipid levels were detected in plasma and ascites samples from patients with ovarian cancer compared with samples from healthy controls or patients with nonmalignant diseases. These lysolipids regulate growth adhesion, production of angiogenic factors, and chemotherapeutic drug resistance in ovarian cancer cells. Ovarian cancer cells were likely to be at least one of the sources for elevated lysolipid levels in the blood and ascites of patients with ovarian cancer. CONCLUSIONS: Bioactive lysolipid levels might be sensitive markers for detecting gynecologic cancers, particularly ovarian cancer. The prognostic value of lysolipids in ascites is worth further investigation. Bioactive lysolipid molecules can affect both the proliferative and metastatic potentials of ovarian cancer cells; therefore, regulation of the production or degradation of these lipids and interception of the interaction between these lipids and their receptors could provide novel and useful preventative or therapeutic measures.

Management of pelvic abscess during pregnancy: a case and review of the literature.

UNLABELLED: Cases of pelvic or abdominal abscess complicating pregnancy are rare. Noninvasive diagnostic techniques including ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) have enabled early diagnosis of this unusual complication of pregnancy. We describe a patient in whom the diagnosis of a pelvic mass was made by sonography and MRI at 25 weeks' gestation. At laparotomy, a pelvic abscess was partially resected and drained. Two weeks later when the patient again became symptomatic, a recurrent pelvic abscess was detected by CT and treated with intravenous antibiotics and CT-guided transcatheter drainage. The patient's recovery was thereafter uncomplicated and she delivered a healthy male infant by elective repeat cesarean at 38 weeks' gestation. The literature concerning pelvic and abdominal abscesses during pregnancy is reviewed. The potential advantages of imaging-guided, percutaneous transcatheter drainage for the treatment of such patients are emphasized. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader will be able to understand the nonsurgical alternatives for the drainage of intraabdominal abscesses, the possible etiologies of intraabdominal abscess formation in the pregnant population, and the various approaches to percutaneous catheter drainage of intraabdominal abscesses.

Transvaginal sonographic depiction of aborting pedunculated intracavitary uterine leiomyoma.

We present an unusual case in which, following indeterminate findings on transabdominal sonographic assessment, transvaginal sonography clearly depicted an aborting pedunculated intracavitary leiomyoma within the uterine cervix. The lesion measured 4x4 cm and exhibited central cystic degenerative changes.

Acute oligohydramnios and deteriorating fetal biophysical profile associated with severe preeclampsia.

Acute changes in fetal biophysical profile (BPP) status usually include rapid cessation of all nonessential acute biophysical activities, yet not necessarily an acute decrease in the amniotic fluid volume, or oligohydramnios. A 36-year-old para 3 with early third-trimester severe preeclampsia, mild placental abruption, and fetal growth restriction, with a reassuring BPP of 8/8, was managed expectantly with intravenous magnesium sulfate, hydralazine, and intramuscular corticosteroids. Within 20 h of admission a marked change in the BPP was noted, with a score of 0/8. Amniotic fluid index (AFI), which on admission had been 20.1, progressively became 0, despite a stable normovolemic maternal status. At immediate cesarean, a mildly acidotic and hypoxic fetus was delivered which subsequently did well. This case supports the concept that acute oligohydramnios may develop rapidly in the presence of acute fetal hypoxemia.

Extensive spontaneous retroperitoneal hemorrhage: an unusual complication of heparin anticoagulation during pregnancy.

A 27-year-old patient at 13 weeks' gestation maintained on subcutaneous heparinization due to hemoglobin S and hemoglobin C (SC) sickle cell disease and previous splenic vein thrombosis presented with spontaneous acute onset of severe left lower abdominal and groin pain. The pain, which radiated to the anterior aspect of the thigh, was associated with nausea and vomiting and was exacerbated by extension of the left lower extremity. The patient was hemodynamically stable, yet during the first 24 h of hospitalization a marked decrease in hematocrit from 29% to 22% occurred. Contrast computed tomography (CT) revealed an extensive abdominal-pelvic, retroperitoneal hematoma extending approximately 15 cm in length from above L5 cephalad to below the greater trochanter of the left femur caudally. The retroperitoneal hemorrhage self-tamponaded and did not require surgical management. The dosage of heparin was decreased and maintained with appropriate activated partial prothrombin (aPTT) levels. To our knowledge, this is the first report of a spontaneous retroperitoneal hemorrhage complicating heparin anticoagulation in pregnancy. Unusual hemorrhagic complications of anticoagulation therapy are discussed.

Intrapartum ultrasonographic depiction of fetal malpositioning and mild parietal bone compression in association with large lower segment uterine leiomyoma.

With normal flexion of the fetal head prior to and during early normal labor, the fetal biparietal diameter becomes engaged in (and subsequently traverses) the anterior posterior aspect of the pelvic inlet. Thus, the biparietal diameter (characterized sonographically by depiction of the falx cerebri, thalami, and cavum septum pellucidum) will be obtainable upon transverse suprapubic placement of the ultrasound transducer during the first stage of labor. Deflexion, or extension, of the fetal head may be demonstrated sonographically at the level of the cervical spine. Recently, during intrapartum ultrasonographic assessment of a nulliparous patient with a known, large, lower-segment, uterine fibroid, exhibiting poor progress of labor, the fetal biparietal diameter was documented upon midsagittal suprapubic placement of the transducer. In addition, mild compression of the distal parietal fetal bone was demonstrated and considered consistent with compression by the leiomyoma. Following abdominal delivery, due to fetal distress and arrest of descent, significant deflexion of the fetal head (not suspected by intrapartum cervical examinations) and mild parietal bone depression, consistent with the ultrasonographic examination, were noted.

Dermatofibrosarcoma protuberans of the vulva: a rare tumor presenting during pregnancy in a teenager.

OBJECTIVES: We report a case of a young patient with dermatofibrosarcoma protuberans of the vulva diagnosed during pregnancy. We also provide a review of the literature on this topic. MATERIALS AND METHODS: This patient's case was reviewed retrospectively. A current literature search was performed and findings were reported. RESULTS: This rare malignancy was diagnosed during pregnancy in a teenager. CONCLUSIONS: Dermatofibrosarcoma protuberans of the vulva, a rare vulvar neoplasm mostly associated with older patients and never before reported during pregnancy, should be considered as part of the differential diagnosis for any vulvar mass and cannot be excluded on the basis of the patient's age or pregnancy status.

Aesthetic breast surgery.

Throughout documented history man has admired physical beauty. Artistic works such as the Venus de Milo and Michelangelo's David and contemporary movie stars and athletes emphasize the physical being. More than mere appreciation of corporeal attributes, ours is a reverence which perceptually bestows a halo effect of associated virtues. If certain physical criteria are met, the individual simultaneously is presumed intelligent, strong, charming, good, or any of a number of other socially esteemed characteristics. In a highly competitive society, it is no wonder we strive for the edge which beauty bestows.

Preoperative Orthoplast splinting in cross-leg flaps.

A case of a cross-leg flap has been presented with preoperative application and molding of splints made from Orthoplast. The advantages of this technique have been presented.

Fungi in and around implants after augmentation mammaplasty.

Four cases of possible fungal infections after 700 augmentation mammaplasties are presented in a 9-year experience. The source could not be determined. If any readers have had one or more similar cases, we would appreciate your contacting us.