Infrared investigations of 4-hydroxycyanobenzene single crystals.

4-Hydroxycyanobenzene (4HCB) single crystals (SCs) and polycrystals (PCs) have been analyzed by means of both unpolarized and linearly polarized (LP) infrared (IR) beams. Most of the signals found at room temperature (298 K) were assigned to well-defined vibrational modes. Using an LP-IR beam and keeping the beam polarization aligned with either the a or the b crystal axis, anisotropic spectra of SCs were also attributed. The differences between the LP and unpolarized spectra of SCs are discussed in view of spatially anisotropic vibronic couplings between the benzenic π electrons and the molecular functional groups (FGs), with reference to the overall lattice arrangement and the polarizability of the FGs. In addition, signals suggesting the low-concentration presence of tautomers within the crystal were detected. LP-IR measurements of SCs in the temperature range between 298 and 120 K are also reported and discussed, with particular reference to the hydrogen-bonding-related functional groups of 4HCB, allowing the assignment of OH bending signals that were otherwise not clearly attributable and the inference of an anisotropic shrinking of the crystals. Overall, the presented results show that LP-IR spectroscopy is a valuable tool for noncontact, nondestructive characterization of organic semiconducting single crystals.

Is it possible to obtain a presurgical Lasmar score for hysteroscopic myomectomy by ultrasound alone?

OBJECTIVE: To determine whether a Lasmar score obtained entirely by the use of two-dimensional (2D) and three-dimensional (3D) ultrasound provides results similar to those obtained using the original hysteroscopic technique. METHODS: This was a prospective study performed on a series of patients presenting with symptomatic submucous fibroids and scheduled for hysteroscopic myomectomy. Ultrasound Lasmar scores were obtained by a single physician, a specialist in ultrasonography, in the luteal phase of the menstrual cycle. 3D images were evaluated by offline examination using multiplanar analysis. Classical Lasmar scores were obtained by a different physician, a specialist in hysteroscopy, during the follicular phase of the subsequent cycle. Surgery was performed by a third physician in the follicular phase who also reported a Lasmar score, which we considered as the gold standard. The concordance between group classifications (I-III, relating to difficulty of hysteroscopic resection) according to the three methods used to obtain the Lasmar score (ultrasound, classical and surgery) was calculated using Cohen's κ statistic. RESULTS: Thirty-four women, with a mean age of 43 ± 4.9 years, were enrolled in the study. Thirty-six submucous fibroids were identified by both ultrasound and diagnostic hysteroscopy. The mean diameter of fibroids evaluated was 28 ± 13.2 mm. The concordance between the three methods of classifying patients according to Lasmar score was high: classical vs. surgery, κ = 0.88; ultrasound vs. surgery, κ = 0.93; and classical vs. ultrasound, κ = 0.77. CONCLUSION: The Lasmar score can be obtained solely by ultrasound examination performed in the luteal phase of the menstrual cycle, avoiding office hysteroscopy without a loss of diagnostic accuracy.

Endometrial carcinoma in women 45 years of age or younger.

Adenocarcinoma of the endometrium in patients 45 years or age of younger accounts for 21% of all endometrial neoplasms diagnosed. The clinical and pathological findings in 17 cases of endometrial adenocarcinoma patients aged 45 years or younger treated between January 1976 and December 1992 in Department B of the Gynecologic and Obstetric Institute, University of Torino, Italy are reported. The patients age ranged from 31 to 45 years, with a median age of 39.3 years. Thirteen of the 17 neoplasms (76.4%) were stage IB (FIGO 1988), two (11.7%) stage IIB, one (5.8%) IIIC and one IVA. Histologically all patients had endometrial adenocarcinoma, eight were well-differentiated tumors (G1), six were moderately-differentiated tumors (G2) and three poorly-differentiated tumors (G3). Three of the patients treated from 1976 to 1979 received post-operative administration of 17-hydroxiprogesterone-19-norcapronate (500 mg i.m. weekly for one year) and 14 of the patients treated from 1980 to 1992 received, according to neoadjuvant hormonal protocols, Medroxiprogesterone acetate (MPA) 1,000 mg daily per os for 90 days and 500 mg per os for one year. The aim of this paper is to draw attention to the existence of this neoplasm in an unexpected age range.

Reduced IL-2 level concentration in patients with breast cancer as a possible risk factor for relapse.

Reduced interleukin 2 (IL-2) production has been described as one of the most frequent immune dysfunctions observed at relapse in patients with disseminated solid neoplasms. It was seen that patients treated for breast cancer (NED-no evidence of disease- at check-up) have a relapse percentage of 4.7% if the IL-2 plasmatic level is normal while the relapse percentage increased to 33.3% if it is low after a 10-12 month follow-up. This link between low IL-2 and the host immune response is a new prognostic indicator and one not strictly related to the tumour itself.

Tamoxifen and endometrial cancer: new data for an old problem. Review.

Tamoxifen, a nonsteroidal antiestrogen, is used for pre- and postmenopausal patients with breast cancer. Data on a possible association of endometrial pathologies with Tamoxifen treatment have been accumulating. The current literature and our experience are presented.

Complications of pelvic and para-aortic lymphadenectomy in patients with endometrial cancer.

The International Federation of Gynecology and Obstetrics (FIGO) changed the staging criteria for endometrial cancer in 1988 and adopted a surgical-pathological staging involving also pelvic and/or para-aortic lymphadenectomy. A total of 236 patients were treated for endometrial adenocarcinoma at Department B of the Gynecologic and Obstetrics Institute, University of Turin, between January 1976 and December 1995. Our protocol for surgical staging always entails pelvic and para-aortic lymphadenectomy and a simple total hysterectomy and bilateral adnexectomy with removal of the upper third of the vagina. The aim of this study was to carry out a retrospective evaluation of the morbidity in patients with endometrial cancer after surgical treatment, either TAH-BSO alone or TAH-BSO with pelvic and para-aortic lymphadenectomy.

Advanced primary squamous carcinoma of the vagina treated with carboplatinum (JM 8). A case report.

Primary cancer of the vagina is one of the rarest malignant neoplasms: radiotherapy is the most frequently used treatment and local recurrences remain a constant problem. We describe a case of invasive squamous carcinoma of the vagina submitted to neoadjuvant therapy with carboplatinum. Pathological findings after surgery were completely negative for cancer.

Microinvasive carcinoma of the uterine cervix. Diagnostic and therapeutic dilemma.

Squamous microcarcinomas of the uterine cervix represent a focus of controversy regarding a useful clinical definition. The confusion of terminology and numerous pathological definitions have led to a great variety of surgical treatments from the cone to the radical hysterectomy, with pelvic adenectomy. This report analyses retrospectively 133 cases of Stage IA cervical cancers which have been followed up for 10-240 months. The purpose of this work is to seek a uniform therapeutical approach to cervical microcarcinoma with the review of International Literature.

Endometrial carcinoma in breast cancer patients treated with tamoxifen. Two case report and review of the literature.

Recent reports suggest an increased incidence of endometrial cancer in breast cancer patients under long-term adjuvant tamoxifen (TAM) treatment. The Authors describe two cases of endometrial adenocarcinoma among 80 post-menopausal patients affected with breast cancer and treated with TAM.

[A new method of neovagina in Rokitansky's syndrome. A review of the literature and description of a series]. / Proposta di nuova metodica di neovagina nella sindrome di Rokitansky. Revisione della letteratura ed illustrazione della casistica.

BACKGROUND: The absence or hypoplasia of the vagina is a frequent finding in Rokitansky-Mayer-Küster-Hauser syndrome. METHODS: A group of 13 patients with Rokitansky-Mayer-Küster-Hauser syndrome were treated between 1982 and December 2001 at the Plastic Surgery Department of C.T.O. (Turin) and the 2nd Obstetrics-Gynecology Clinic of Turin University. Surgery was the proposed therapy in all patients, using a modified version of the McIndoe technique. RESULTS: In this series, the cytological tests of neovaginal tissue carried out one year after surgery showed a syndrome of slight atrophy in 8 cases, but this was not sufficient to impede the sexual activity of these patients. Two patients were lost in the follow-up; 3 patients declared that they were reasonably satisfied with their sex life, whereas the remaining 8 reported a normal sex life. CONCLUSIONS: The treatment of choice for complete vaginal agenesia is a neovagina using the skin graft method. This technique produces excellent anatomical results, especially in young patients, even without regular dilatation or frequent sexual relationships. The only drawback of this method is that the vagina tends to retract in some patients, a problem that has been largely solved by the most recently proposed surgical variants.

Cervical cerclage for the treatment of patients with placenta previa.

Over a ten year period, placenta previa occurred in 103 instances among 12,965 deliveries. In six of these, cervical cerclage was undertaken to prevent severe bleeding while prolonging pregnancy between the 24th and the 30th weeks of gestation, according to the McDonald technique. We performed cesarean section delivery in all cases. The medium prolongation of the pregnancy was of 8.2 weeks and the foetus weighed from 1,820 to 3,360 g. No complications due to fetal respiratory distress were observed. No patients needed transfusions. Postpartum and the puerperium were regular. These results support the use of cervical cerclage for the treatment of patients with symptomatic placenta previa early in gestation.

Grand multiparity: a study of 168 cases.

The aim of this retrospective study was to consider the problem of grand multiparity in our female population to evaluate if grand multiparity represents a real risk factor for pregnancy, delivery and fetal well-being. From 1981 to 1989 the Gynaecology and Obstetrics Institute of Turin University together with St. Anna Hospital of Turin carried out a retrospective study on pregnancy course, delivery and fetal status in 168 women who had had four or more pregnancies and in 5320 multiparous women who had parity < 4. We analyzed the parity distribution in the different ages with the aid of the registry office and by consulting patient's obstetric clinical history. We evaluated the incidence of gestational complications in the multiparous group. Finally we studied the delivery modality and perinatal mortality in 72,907 births from 1981 to 1989.

Two cases of ovarian cysts in postmenopausal patients under antiestrogen treatment.

In 20% of premenopausal breast cancer women on Tamoxifen (TAM) treatment there is an ovarian enlargement: in literature one case of acutely cystic ovaries is described. We observed 2 cases of acutely cystic ovaries in postmenopausal women surgically treated during a long-term adjuvant therapy with TAM.

Leiomyomas in patients receiving Tamoxifen.

In literature there have been only 8 cases of unavoidable laparotomy due to uterine leiomyomas performed in patients with breast cancer on Tamoxifen (TAM). Our article describes two cases of rapidly growing leiomyomas in patients treated with TAM: one of these underwent abdominal hysterectomy while the second stopped taking TAM and began therapy with Triptorelin. This therapeutical alternative could be a useful choice.

Surgical management of leiomyomata in pregnancy.

A review was made of the medical records of 26 patients with uterine myomas during pregnancy between 1983 and 1992 among 12,965 deliveries. Thirteen patients underwent myomectomies before pregnancy. In three patients myomectomy was performed during pregnancy between the 12th and the 19th week of pregnancy. In ten patients myomectomy was performed during cesarean section delivery to prevent necrobiosis. Myomectomy should remain exceptional during pregnancy and it must be performed only in selected cases but is frequently used towards the end of a cesarean section. Indications for hysterectomy, on the other hand, remain limited.

Cervical cerclage for malformed uterus.

The role of cervical cerclage was evaluated in six pregnant women with anomalous uterus. Early prophylactic cerclage according to the Shirodkar and McDonald technique was done on all cases of uterine malformation (except septate uterus) with or without cervical incompetence in association with progesterone and antispastic therapy. Improvement in obstetrical outcome was noted after cerclage. Even if no doubt exists as to the need for cerclage in cases of cervical incompetence, the concept of routine prophylactic cerclage in all cases of uterine anomalies should be considered.

Management of patients with intrauterine fetal death.

Fetal death incidence is 5-10 per 1,000 births. About 25% of the women who carry a dead fetus for more than 4 weeks will show significant alterations in their coagulation system. The treatment for a patient with endouterine fetal death depends on when the pregnancy is terminated, based on the ecographic fetus age. There were 15,070 births from January 1983 to December 1994 in Department B of the Institute of Obstetrics and Gynecology, University of Torino. We took into consideration the cases ofintrauterine fetal death between the 26th and 40th week before labour. This study is based on a cohort of 57 cases of intrauterine fetal demise from the 24th to the 40th week of pregnancy before spontaneous labour.