Mixed mesodermal sarcoma of the ovary in a young patient.

Mixed mesodermal tumors (MMT) of the ovary are rare and have a poor prognosis. This ovarian malignancy usually occurs in postmenopausal women. We report an unusual ovarian MMT in a young woman given treatment similar to one used for ovarian germ cell malignancies.

AIDS risk behaviours and correlates in teenagers attending sexually transmitted diseases clinics in Los Angeles.

Objective: Of all age groups, teenagers have the highest rates of sexually transmitted diseases. Therefore, it is particularly important to target interventions at this group. Teenagers attending STD clinics are at particularly high risk since behaviours that lead to an STD can also result in the transmission of HIV.

Initial and repeat mammography screening in a low income multi-ethnic population in Los Angeles.

Low income, older, minority women are at high risk for underutilization of screening mammography. One strategy for increasing utilization is to conduct interventions targeting local and state health departments where a majority of these women seek health care. A prerequisite for conducting effective screening programs is to obtain current and accurate information on baseline screening rates to understand the nature and scope of the problem and to plan appropriate intervention strategies.

Long-range effect of clinical trial interventions on quality of life.

Phase III randomized clinical trials have been designed primarily to answer questions of clinical efficacy. Although the primary outcome for most clinical trials is improved survival or disease free survival, recent studies have also compared the efficacy of treatments with no anticipated effects on survival but with different toxicities or rehabilitation outcomes. By identifying treatments with less morbidity, clinical trials have contributed to improving the quality of life of patients with cancer.

The influence of tumor grade, distribution, and extent of carcinomatosis in minimal residual stage III epithelial ovarian cancer after optimal primary cytoreductive surgery.

The purpose of this study was to determine the influence of tumor grade, distribution, and extent of carcinomatosis in minimal residual epithelial ovarian cancer after primary optimal cytoreductive surgery. Between 1978 and 1990, 112 patients with stage III epithelial ovarian cancer underwent primary cytoreductive surgery and had minimal residual disease, i.e.

Advances in the biology of gynecologic cancer.

This review discusses recent insights into the roles of the p53 tumor-suppressor gene and growth factors in the development of ovarian cancer and describes the genes implicated in familial ovarian cancer syndromes related to the MSH2 (Lynch II) and BRCA1 (breast and ovarian cancer) genes. Evidence of the monoclonality of ovarian cancer, which contrasts with data supporting the polyclonal origin of primary peritoneal carcinoma, is presented. Finally, the roles of the human papillomavirus and the HIV virus in the etiology of cervical cancer are analyzed in view of the growing importance of this HIV-associated cancer and the poor outcome in these patients.

Quality of life and the patient with cancer. Individual and policy implications.

This article reviews the developments during the past decade that have led to a better definition and conceptualization of the term "quality of life." There is growing consensus regarding the dimensions of quality of life, along with an expansion of the number of tools appropriate for measuring quality of life in patients with cancer. Quality of life increasingly is being used as an outcome in research, especially clinical trials.

Conservative and individualized surgery for early squamous carcinoma of the vulva: the treatment of choice for stage I and II (T1-2N0-1M0) disease.

We studied the outcome of patients undergoing radical local excision (modified radical vulvectomy) with inguinal-femoral lymphadenectomy through separate groin incisions for stage I and II invasive squamous carcinoma of the vulva. The purpose was to determine whether less radical and more individualized surgery is consistent with local control and cure. We have reported previously our experience using radical local excision and modified radical vulvectomy in stage I disease (Obstet.

Solitary recurrent metastasis of epithelial ovarian cancer in the spleen.

In epithelial ovarian cancer, solitary metastasis to and recurrences in the parenchyma of the spleen are rare in the absence of apparent disease in other sites. We report four patients who developed isolated, solitary splenic parenchymal recurrences of their epithelial ovarian adenocarcinomas and underwent a splenectomy to remove the recurrent disease. They had undergone optimal cytoreductive surgery for stage III grades 2-3 serous cystadenocarcinoma of the ovary, followed by six to nine cycles of cisplatin and cyclophosphamide chemotherapy and a negative second-look laparotomy.

Molecular and biological factors in the pathogenesis of ovarian cancer.

Background: The classic prognostic parameters are insufficient for predicting the prognosis of the individual patient. Knowledge of molecular and biological factors which are responsible for the development and progression of ovarian cancer may improve the prediction of prognosis.

Materials And Methods: Recent data both on factors associated with the development and control of ovarian cancer cells and on DNA ploidy have been reviewed.

Presence of interleukin 10 (IL-10) in the ascites of patients with ovarian and other intra-abdominal cancers.

Typically, ovarian cancer remains restricted to the peritoneal cavity. Because of this unique localization, the study of ovarian cancer is particularly suitable for immune analysis and for the development of immunotherapy. Here we report that peritoneal fluid from patients with ovarian or other intra-abdominal cancers contained significantly elevated levels of interleukin 10 (IL-10) (542 +/- 77 pg/ml, N = 35), compared with peritoneal fluid from patients with benign gynecological conditions (34.

Identity formation and social maladaptation in foster adolescents.

The literature on identity formation in individuals from socially devalued racial and ethnic groups in the United States is summarized. Implications are discussed for a particular segment of at-risk adolescents--those in foster care residential group homes--who have received little published attention. The majority, in large urban centers, are African-American or Latino.

Quantitative and qualitative assessment of a case management program for cancer patients.

An oncology social work case management model of intervention is described quantitatively and qualitatively. Sixty-nine newly diagnosed breast cancer patients followed by telephone for one year required 374 hours of the social worker's time in providing reassurance, information, and referral to existing community resources. This process took less than one-half hour per patient per month.

Fine-needle aspiration cytology accuracy with palpable gynecologic neoplasms.

From 1984 to 1988, 62 fine-needle aspirations (FNA) were performed on palpable lesions in 59 gynecologic oncology patients at the UCLA Medical Center. Sites of aspiration included abdomen, cervix, vagina, superficial lymph nodes, and pelvic masses. Confirmatory open biopsy (41) or adequate clinical follow-up (17) was obtained in 55 patients (58 aspirates).

Two signals mediate nuclear localization of influenza virus (A/WSN/33) polymerase basic protein 2.

Polymerase basic protein 2 (PB2), a component of the influenza virus polymerase complex, when expressed alone from cloned cDNA in the absence of other influenza virus proteins, is transported into the nucleus. In this study, we have examined the nuclear translocation signal of PB2 by making deletions and mutations in the PB2 sequence. Our studies showed that two distant regions in the polypeptide sequence were involved in the nuclear translocation of PB2.

Surgical staging of cervical cancer.

Noninvasive radiologic methods to detect paraaortic lymph node metastases are reliable when combined with FNA of enlarged lymph nodes. However, the sensitivity is low, and undetected microscopic metastases leads to treatment failure. These patients with paraaortic lymph node metastasis are not treated with extended-field radiation, and they all die within 3 years.

Synergy is documented in vitro with low-dose recombinant tumor necrosis factor, cisplatin, and doxorubicin in ovarian cancer cells.

Ovarian carcinomas have been shown to be sensitive or insensitive to the in vitro exposure of several cytotoxic drugs and cytokines. Because of the potential for cytokines to enhance the efficacy of chemotherapeutic agents and to improve their therapeutic index, the optimal dose and schedule of the combination of these agents have been studied. We examined the cytotoxic effect of a combined modality using a variety of concentrations of recombinant tumor necrosis factor (rTNF) (a cytotoxic cytokine) with Adriamycin (ADR) and cisplatin (CDDP) on human ovarian carcinoma cell lines.

Cytoreductive surgery for advanced ovarian cancer: cardiovascular evaluation with pulmonary artery catheters.

Twenty-three patients underwent pulmonary artery (Swan-Ganz) catheterization for hemodynamic monitoring immediately after cytoreductive surgery for advanced ovarian cancer. Seventeen patients were studied continuously for at least 24 hr to determine the postoperative hemodynamic changes; 6 patients were intermittently monitored. The mean age was 63 years, mean operating time was 4.

Resection of diaphragmatic peritoneum and muscle: role in cytoreductive surgery for ovarian cancer.

Fourteen patients undergoing primary cytoreductive surgery for stage III ovarian malignancies had diaphragmatic peritoneum, muscle, or both resected in an attempt to remove all metastatic disease greater than 0.5 cm in diameter. Resection was completed in 13 of 14 patients (93%), all obtaining optimal cytoreduction.