Endotoxin-Free E. coli-Based Cell-Free Protein Synthesis: Pre-Expression Endotoxin Removal Approaches for on-Demand Cancer Therapeutic Production.

Approximately one third of protein therapeutics are produced in Escherichia coli, targeting a wide variety of diseases. However, due to immune recognition of endotoxin (a lipid component in the E. coli cell membrane), these protein products must be extensively purified before application to avoid adverse reactions such as septic shock.

Phase II trial of albumin-bound paclitaxel and granulocyte macrophage colony-stimulating factor as an immune modulator in recurrent platinum resistant ovarian cancer.

Background: Granulocyte macrophage colony-stimulating factor (GM-CSF) stimulates immunity via recruitment of antigen presenting cells and tumor specific T-cell stimulation. Albumin-bound paclitaxel (nab-paclitaxel) followed by GM-CSF may enhance antitumor responses and prolong remissions in ovarian cancer. Immune phenotypes present before treatment may identify responders to chemo-immunotherapy.

Implementing the "Flipped Classroom" on a Gynecologic Oncology Service.

Objective: To determine the impact of a new cur- riculum based on the "flipped classroom" model on the gynecologic oncology (gyn onc) section of the annual in-service examination for residents in obstetrics and gynecology.

Study Design: We intro- duced a curriculum focused on a weekly topic for teach- ing the residents on the gyn onc service in January of 2009. We compared the over- all mean gyn onc-specific percent-correct scores on the in-service examination be- fore (1999-2009) and after (2010-2011) the implemen- tation of the curriculum using linear regression to estimate the mean percentage point change and 95% confidence interval, adjusting for clustering by residents.

Prognostic impact of marital status on survival of women with epithelial ovarian cancer.

Objectives: The objective of this study is to examine the impact of marital status on survival of patients with epithelial ovarian cancer (EOC).

Methods: Patients with a diagnosis of EOC were identified from the Surveillance, Epidemiology, and End Results Program for the period 1988-2006 and divided into married and unmarried groups. Statistical analysis using Student's t-test, Kaplan-Meier, and Cox regression proportional hazards was performed.

Prognostic impact of lymphadenectomy in clinically early stage malignant germ cell tumour of the ovary.

Background: The aim of this study was to determine the impact of lymphadenectomy and nodal metastasis on survival in clinical stage I malignant ovarian germ cell tumour (OGCT).

Methods: Data were obtained from the National Cancer Institute registry from 1988 to 2006. Analyses were performed using Student's t-test, Kaplan-Meier and Cox proportional hazard methods.

Disparities in treatment and survival between African American and White women with vaginal cancer.

Objective: The study aims to compare the difference in treatment and survival between White (W) and African American (AA) patients with vaginal cancer (VC).

Methods: Patients with a diagnosis of invasive vaginal cancer were identified from Surveillance, Epidemiology, and End Results (SEER) program from 1988 to 2007 and were divided into White (W) and African American (AA) subgroups. Student's t test, Kaplan-Meier survival methods, and Cox regression proportional hazards were performed.

Pelvic exenteration in the age of modern chemoradiation.

Background: To examine outcomes after pelvic exenteration in women treated with modern chemoradiation and surgical techniques.

Methods: All patients at our institution with a diagnosis of gynecologic malignancy who underwent pelvic exenteration after treatment with chemoradiation between 1/90 and 6/08 were evaluated with a retrospective chart review.

Results: 44 women were identified, of whom 29 (66%) had cervical, 6 (14%) had uterine, 5 (11%) had vaginal, and 4 (9%) had vulvar cancer.

The prognostic impact of the ratio of positive lymph nodes on survival of epithelial ovarian cancer patients.

Background And Objectives: To study the prognostic significance of ratio of positive to examined lymph nodes (LNR) on survival of patients with node positive epithelial ovarian cancer (NPEOC).

Methods: Data were obtained from Surveillance, Epidemiology, and End Results Program (SEER) from 1988 to 2006, and analyzed using Kaplan-Meier survival and Cox regression proportional hazard methods. Patients were divided into: stage IIIC group 1 (no macroscopic peritoneal disease), stage IIIC group 2 (macroscopic peritoneal disease), and stage IV.

FOXP3+ regulatory T-cells are abundant in vulvar Paget's disease and are associated with recurrence.

Objective: To characterize clinical features of vulvar Paget's disease, and examine the quantity of immunosuppressive regulatory T-cells in vulvar Paget's tissue.

Methods: Vulvar Paget's cases from 1992 to 2007 from two institutions were identified by pathology database search. Regulatory T-cells were identified with FOXP3 immunohistochemistry and quantified at the dermal-epidermal junction using image analysis software.

A phase I trial of dose-dense (biweekly) carboplatin combined with paclitaxel and pegfilgrastim: a feasibility study in patients with untreated Stage III and IV ovarian, tubal or primary peritoneal cancer: a Gynecologic Oncology Group study.

Purpose: Dose-dense regimens have been shown to improve outcome when given as adjuvant therapy to patients with breast cancer compared with their three weekly counterparts. We investigated the feasibility of a dose-dense regimen with carboplatin/paclitaxel followed by pegfilgrastim in patients with advanced ovarian cancer. We also investigated the toxicities including the percentage of patients with grade 2 or greater peripheral neurotoxicity and the clinical response of this regimen.

Ovarian cancer in the elderly: outcomes with neoadjuvant chemotherapy or primary cytoreduction.

Background: Recent studies have suggested inferior outcomes for elderly women with ovarian cancer. Our goal was to evaluate neoadjuvant chemotherapy versus primary cytoreduction in elderly women.

Methods: A retrospective chart review was performed for women aged 65+ diagnosed with ovarian cancer at our institution between 1997 and 2007.

Alternative intraperitoneal chemotherapy regimens for optimally debulked ovarian cancer.

Objective: GOG 172 showed a survival benefit with intraperitoneal (IP) cisplatin for advanced ovarian cancer, but patients tolerated the regimen poorly. We hypothesized that women treated with alternative IP chemotherapy strategies may have less toxicity and improved compliance.

Methods: We reviewed the records of women with ovarian cancer and optimal surgical debulking who underwent IP chemotherapy at our institution.

An evaluation of cervical cancer in women age sixty and over.

Objective: To assess prior cervical cancer screening, stage at time of diagnosis and outcome in women sixty years of age and over with cervical cancer.

Methods: A retrospective review of cervical cancer patients evaluated at the University of Washington identified a cohort of women age sixty and older with cervical cancer diagnosed between January 1, 1993 and December 31, 2003. Electronic medical records and the University of Washington Tumor Registry were reviewed for age, ethnicity, cervical cancer risk factors, pathology, treatment, and outcome.

Kinetics of tumor-specific T-cell response development after active immunization in patients with HER-2/neu overexpressing cancers.

The ability of a cancer vaccine to elicit a specific measurable T-cell response is increasingly being used to prioritize immunization strategies for therapeutic development. Knowing the optimal time during a vaccine regimen to measure the development of tumor-specific immunity would greatly facilitate the assessment of T-cell responses. The purpose of this study was to overview the kinetics of HER-2/neu-specific T-cell immunity evolution during and after the administration of HER-2/neu peptide-based vaccination in the adjuvant setting.

Antibody immunity to the p53 oncogenic protein is a prognostic indicator in ovarian cancer.

Purpose: Presence of intratumoral T-cell infiltration has been linked to improved survival in ovarian cancer patients. We questioned whether antibody immunity specific for ovarian cancer tumor antigens would predict disease outcome. We evaluated humoral immune responses against ovarian cancer antigens p53, HER-2/neu, and topoisomerase IIalpha.

Weekly gemcitabine and cisplatin in combination with pelvic radiation in the primary therapy of cervical cancer: a phase I trial of the Puget Sound Oncology Consortium.

Objective: Define the maximum tolerated dose of weekly gemcitabine given concomitantly with standard weekly cisplatin and pelvic radiotherapy for primary treatment of cervical cancer.

Methods: Gemcitabine at specified dose levels was given concomitantly with weekly cisplatin at 40 mg/m2 for six cycles with concurrent radiotherapy in primary therapy of stage IB-IVA cervix cancer. Radiation consisted of 4500-5000 cGy in 25 daily fractions combined with brachytherapy to take point A to > or = 8500 cGy.

Surgery for ovarian cancer: rationale and guidelines.

Ovarian cancer is the second most common gynecologic cancer in women and the leading cause of death caused by gynecologic malignancy. Surgery plays a fundamental role in treating this challenging disease. Goals of primary surgery for ovarian cancer are to establish diagnosis, proper staging, determination of prognosis, and optimal cytoreduction of gross disease before chemotherapy for improved outcome.

Radiofrequency ablation of liver metastasis from ovarian adenocarcinoma: case report and literature review.

Background: Radiofrequency ablation (RFA) is a minimally invasive technique that can eradicate malignant disease in the liver, including metastatic disease from gynecological primary tumors.

Case: An 81-year-old female underwent percutaneous RFA for a solitary intrahepatic metastatic lesion that was her only known site of disease 2 years after definitive surgery and chemotherapy for stage IIIC ovarian adenocarcinoma. She was able to start systemic chemotherapy 1 week after RFA, and continues to be free of disease in the liver.

Cyclooxygenase (COX)-2 and granulosa cell apoptosis in vitro.

Purpose: C-myc was studied in cyclooxygenase (COX)-2 associated granulosa cell apoptosis,

Methods: Granulosa cells (N = 5 cases) were incubated for 24 h in either 1 or 50 microM COX-2 inhibitor, 1 or 50 microM COX-1/COX-2 inhibitor, negative or positive controls Single primer polymerase chain reaction of c-myc exon 1 were performed. Bisbenzimide-stained control single-stranded (ssDNA) were hybridized to SYBR Gold-stained ssDNA and fluorescent images analyzed.

Results: C-myc was disrupted by the high-dose COX-2 inhibitor.

The use of conscious sedation for outpatient dermatologic surgical procedures.

Background: Dermatologic surgery has undergone increasing levels of sophistication over the past few decades. Commensurate with this demand, an established anesthesia technique called conscious sedation has been employed.

Objectives: Methods for performing office-based conscious sedation are described.

The combined use of propofol and fentanyl for outpatient intravenous conscious sedation.

Background: Intravenous conscious sedation is currently being widely utilized for outpatient surgery including dermatologic surgery. Even though this type of anesthesia is typically administered by a trained, licensed anesthetist, it is important for dermatologists who either intend to or are currently utilizing this type of anesthesia to be familiar with some of the methods and agents that are commonly employed.

Objective: Propofol and fentanyl are two anesthetic agents that are in prevalent use for skin and soft tissue surgery of brief or limited duration.