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Background: The objective of this study was to compare the accuracy of transabdominal (TAUS) and transvaginal sonography (TVUS) and magnetic resonance imaging (MRI) for the diagnosis of adenomyosis, and to correlate imaging with histological findings.Methods: In a prospective study, 120 consecutive patients referred for hysterectomy underwent TAUS, TVUS and MRI. Results of these examinations were interpreted blindly to histopathological findings.Results: Histological prevalence of adenomyosis and leiomyomas was 33.0 and 47.5% respectively. Adenomyotic uteri were accompanied by additional pelvic disorders in 82.5% of cases. Sensitivity, specificity, and positive and negative predictive values of TAUS and TVUS were 32.5 and 65.0%, 95.0 and 97.5%, 76.4 and 92.8%, and 73.8 and 88.8% respectively. Myometrial cyst was the most sensitive and specific TVUS criterion. In MRI, the presence of a high-signal-intensity myometrial spot was as specific but less sensitive than a maximal junctional zone thickness (JZ(max)) >12 mm and a JZ(max) to myometrial thickness ratio >40%. Sensitivity, specificity, and positive and negative predictive values of MRI were 77.5, 92.5, 83.8 and 89.2% respectively. No difference in accuracy was found between TVUS and MRI, but sensitivity was lower with sonography in women with associated myomas.Conclusions: TVUS is as efficient as MRI for the diagnosis of adenomyosis in women without myoma, while MRI could be recommended for women with associated leiomyoma. [ABSTRACT FROM AUTHOR]

Presents power Doppler ultrasonographic images of suspected adenomyosis. Transvaginal ultrasonic imaging; Heterogeneous echopattern of myometrium.

Abstract Background Lymph node status is an important prognostic factor and a criterion for adjuvant therapy in uterine cancers. While detection of micrometastases by ultrastaging techniques is correlated to prognosis in several other cancers, this remains a matter of debate for uterine cancers. The objective of this review on sentinel nodes (SN) in uterine cancers was to determine the contribution of ultrastaging to detect micrometastases. Methods Review of the English literature on SN procedure in cervical and endometrial cancers and histological techniques including hematoxylin and eosin (H&E) staining, serial sectioning, immunohistochemistry (IHC) and molecular techniques to detect micrometastases. Results In both cervical and endometrial cancers, H&E and IHC appeared insufficient to detect micrometastases. In cervical cancer, using H&E, serial sectioning and IHC, the rate of macrometastases varied between 7.1% and 36.3% with a mean value of 25.8%. The percentage of women with micrometastases ranged from 0% and 47.4% with a mean value of 28.3%. In endometrial cancer, the rate of macrometastases varied from 0% to 22%. Using H&E, serial sectioning and IHC, the rate of micrometastases varied from 0% to 15% with a mean value of 5.8%. In both cervical and endometrial cancers, data on the contribution of molecular techniques to detect micrometastases are insufficient to clarify their role in SN ultrastaging. Conclusion In uterine cancers, H&E, serial sectioning and IHC appears the best histological combined technique to detect micrometastases. Although accumulating data have proved the relation between the risk of recurrence and the presence of micrometastases, their clinical implications on indications for adjuvant therapy has to be clarified.

Abstract Background The aims of this retrospective study were to evaluate laparoscopic triage of patients with advanced ovarian cancer towards primary surgery or neoadjuvant chemotherapy, and to analyze outcome according to the treatment. Methods Between January 2001 and December 2006, 55 patients with stage III – IV ovarian cancer underwent diagnostic laparoscopy. Primary surgery was performed when complete cytoreduction was considered feasible, while the other patients received neoadjuvant chemotherapy (platinum-based combination with taxanes) and interval surgery. All the patients received adjuvant chemotherapy. Results Patients treated with neoadjuvant chemotherapy (n = 29) had a higher mean body mass index (P = 0.048), higher serum CA 125 levels (P = 0.026), and more metastases (P = 0.045) than patients treated with primary surgery (n = 26). In patients treated with primary surgery, complete cytoreduction and a residual tumour size ≤ 2 cm were obtained in respectively 54% and 77% of cases. Complete cytoreduction was achieved in respectively 100% and 33% of cases when primary surgery was performed by an oncologic gynaecologist and by a non-oncologic gynaecologist (P = 0.002). Interval surgery yielded complete cytoreduction and a residual tumour size ≤ 2 cm in respectively 73% and 85% of cases. With a median follow-up of 24 months (range 7 – 78 months), the survival rates after primary surgery and interval surgery were 61% and 66% respectively. Conclusion Diagnostic laparoscopy is useful for identifying patients with stage III/IV ovarian cancer who qualify for primary cytoreduction. Surgeon experience was a determining factor for the success of complete cytoreduction.

Objectives Two large multicenter randomised trials were performed in France to assess whether systematic screening with an artery uteroplacental Doppler (AUD) in low-risk pregnant women followed by the prescription of low-dose aspirin in cases with abnormal results reduced the incidence of intrauterine growth restriction (IUGR) and of preeclampsia. Study design and population The first trial ‘Seine Saint-Denis’ (SSD) trial included 3317 low-risk pregnant women (multi and primigravidae) in 17 French maternity Hospitals and the second ‘Erasme’ trial included 1869 primigravidae in 12 centres. In the Doppler group, the AUD was performed between 20 and 24 weeks, and women with abnormal results received 100 mg of aspirin daily until the 35th week. Results In the Doppler group, 232 patients (15.7%) had an abnormal result in the SSD trial and 20% in the ERASME trial. The predictive value of the AUD was comparable to that reported in the studies of low-risk populations, but with a low sensitivity. Finally, IUGR, whether defined by the third or tenth percentile, and preeclampsia did not differ significantly between the treatment groups in both trials. Conclusions There is no proof justifying the recommendation of a systematic AUD in a low-risk population, even if abnormal results are followed by aspirin treatment and increase in prenatal surveillance. Future studies must assess predictive tests that can be performed early in pregnancy and can identify populations at very high risk of preeclampsia and IUGR. Only when all of these conditions are fulfilled can aspirin prove its efficacy. [ABSTRACT FROM AUTHOR]

Background: Lymphocele is the principal post-operative morbidity following axillary node dissection. According to the literature, the incidence can vary from 4% to 89%. Encouraging results in terms of reducing postoperative lymphoceles as well as the volume and duration of drainage using octreotide LAR has been recently reported. Pasireotide LAR, a long acting drug designed to target multiple somatostatin receptors, was evaluated in this trial. Trial design: A phase II, two centers, randomized, double-blind, non-comparative pilot study was carried out in order to evaluate efficacy and safety of a single injection of pasireotide LAR 60 mg administered 7-10 days before scheduled mastectomy with axillary dissection surgery. This study included a parallel placebo arm to assess the natural course of the disease. Eligibility criteria: Adult female breast cancer patients planned to undergo a mastectomy (without reconstruction at the same time) and axillary node dissection. Specific aims: To assess the efficacy and safety of a single injection of pasireotide LAR 60 mg or placebo prior to mastectomy with axillary lymph node dissection surgery in reducing symptomatic lymphocele development. Symptomatic lymphocele was evaluated and was defined as: 1. total lymphocele drainage/aspiration volume (unique or iterative) >60 cc inclusive within the 28 days after surgery (excluding post-surgery drain) or; 2. a systematic aspiration volume at day 28 > 120 cc. Statistical methods: The statistical analysis was carried out sequentially after observing the absence of symptomatic lymphocele for each patient. It involves estimating the probability of a response in each group using a Bayesian design based on a beta-binomial model. The probability of response was considered random and its prior distribution was centered on 80% in the pasireotide group and 60% in the placebo group according to the investigators initial guesses. The distribution of the probability of response was updated after the observation of the patients included in the trial. Results: A total of 90 patients were included over 18 months: 42 in the treatment group and 48 in the placebo group. In the treatment group, the posterior mean estimation of the response rate (i.e. patients who did not experience a symptomatic lymphocele) was 62.4% (95% CI: 48.6%-75.3%) and 50.2% in the placebo group (95% CI: 37.6%-62.8%%). In the treatment group, one serious adverse event occurred in a patient with known insulin dependent diabetes requiring hospitalization for hyperglycaemia. Conclusion: A one time injection of pasireotide LAR to prevent symptomatic lymphocele development in women undergoing mastectomy with axillary dissection is promising. Further clinical studies are warranted. [ABSTRACT FROM AUTHOR]

The intercalation of pyrazolone-based oxalamide metal complexes into Na-montmorillonite (Na-MMT) for catalytic liquid-phase oxidation of phenol using H 2 O 2 was undertaken by a flexible ligand method using metal ions including Mn(II), Zn(II), and Sn(II). First, the metal ions were exchanged with the sodium ions of Na-MMT, and then these metal ions were complexed with a new pyrazolone-based oxalamide ligand. The intercalated metal complexes were characterized by Fourier transform infrared spectroscopy, X-ray diffraction, scanning electron microscopy, energy-dispersive X-ray spectroscopy, elemental analysis, and thermogravimetric analysis. Phenol was successfully oxidized by heterogeneous catalysts based on Mn(II), Zn(II), and Sn(II) pyrazolone-based oxalamide complexes intercalated into Na-MMT. These heterogeneous catalysts catalyze the liquid-phase oxidation of phenol using H 2 O 2 to catechol as the major product and hydroquinone and benzoquinone as the minor products. The Mn(II) and Zn(II) complexes intercalated into Na-MMT showed better activity than the Sn(II) complex intercalated into Na-MMT and the reaction without the catalyst. It has been shown that some metal ion complexes intercalated into Na-MMT are active catalysts for liquid-phase oxidation of phenol with hydrogen peroxide., (© TÜBİTAK.)

The existing reducing agents used in the literature to decolorization of methylene blue are soluble in water and the reduction process is carried out in a homogeneous redox reaction medium. After the decolorization process, the reducing agents and its by-products remain in a homogeneous redox reaction medium. Many of these reducing agents are toxic and cause chemical pollution of textile wastewater. Therefore, there is a need for reducing agents that can be mixed heterogeneously with water from which the reducing agent can be easily removed from a redox reaction medium. For this purpose, water-insoluble redox active azo polymer was synthesized from redox active 1,4-dihydroxybenzene and p-phenylenediamine. The synthesized redox active azo polymer was used for decolorization of methylene blue by heterogeneous reduction and various kinetic parameters were investigated for this redox reaction. At the same time, the investigated results of azo polymer and monomer (1,4-dihydroxybenzene) were compared., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

To define the prognostic value of isolated tumor cells (ITC), micrometastases (pN1mi) and macrometastases in early stage breast cancer (ESBC). We conducted a retrospective multicenter cohort study at 13 French sites. All the eligible patients who underwent SLNB from January 1999 to December 2008 were identified, and appropriate data were extracted from medical records and analyzed. Among 8001 patients, including 70% node-negative (n = 5588), 4% ITC (n = 305), 10% pN1mi (n = 794) and 16% macrometastases (n = 1314) with a median follow-up of 61.3 months, overall survival (OS) and recurrence-free survival (RFS) rates at 84 months were not statistically different in ITC or pN1mi compared to tumor-free nodes. Axillary recurrence (AR) was significantly more frequent in ITC (1.7%) and pN1mi (1.5%) compared to negative nodes (0.6%). Survival and AR rates of single macrometastases were not different from those of ITC or pN1mi. In case of 2 macrometastases or more, survival rates decreased and recurrence rates increased significantly. Micrometastases and ITC do not have a negative prognostic value. Single macrometastases might have an intermediate prognostic value while 2 macrometastases or more are associated with poorer prognosis., (Copyright © 2014 Elsevier Ltd. All rights reserved.)