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Background: Platinum-based chemotherapeutics are the main treatment options for ovarium cancer. However, the development of drug resistance is one of the major issues in chemotherapy. Even targeting a specific pathway may not produce an efficient sensitization to the chemo agent due to various pathways related to developing resistance against cisplatin. Hence, more effective strategies against drug resistance are essential for cancer treatment. In the presence of the ultrasonic waves, increased membrane porosity enables more drug uptake into the cancer cell. Therefore, the promising method in cancer therapy is seen as the use of the combined effect of chemotherapy and low-Intensity Ultrasound (LIUS) to overcome chemoresistance., Objective: The present study aimed to examine the effects of Ultrasound (US)+Cisplatin (Cis)- based combination therapy to advance an effective treatment against drug resistance in cisplatinresistant ovarian cancer cells A2780 (A2780cis) under in vitro conditions., Methods: Treatment groups as Cis and LIUS with two different ultrasound parameters (10% duty cycle (DC), 1 MHz, 1.0 W/cm 2 , 1 min and 50% DC, 1 MHz, 1.0 W/cm 2 , 3 min) were investigated to cope with the chemoresistance in A2780cis. After Cis therapy with IC 50 concentrations determined in A2780 and A2780cis, drug-sensitive/resistant ovarian cancer cells were treated by ultrasound. The effects of the US+Cis combination therapy were evaluated by cell viability assays, colony formation, and cell cycle analyses., Results: In both US parameters, the waveform was shown to be more effective in preventing drug resistance. While more than 80% of the cell population was suppressed with the US+Cis combination treatment, more than 90% of the colony formation was suppressed according to the colony formation test results. In addition, US+Cis combination therapy caused different cell cycle arrests in both A2780 and A2780cis cells., Conclusion: Ultrasound-based combination therapies show promising results in combating chemoresistance, and the disadvantages of conventional cancer treatments, such as cancer recurrence, drug resistance, and high cost, might reduce by the effectiveness of combination therapy of ultrasound therapy and chemotherapy., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Precise and quick monitoring of key cytometric features such as cell count, size, morphology, and DNA content is crucial in life science applications. Traditionally, image cytometry relies on visual inspection of hemocytometers. This approach is error-prone due to operator subjectivity. Recently, deep learning approaches have emerged as powerful tools enabling quick and accurate image cytometry applicable to different cell types. Leading to simpler, compact, and affordable solutions, these approaches revealed image cytometry as a viable alternative to flow cytometry or Coulter counting. In this study, we demonstrate a modular deep learning system, DeepCAN, providing a complete solution for automated cell counting and viability analysis. DeepCAN employs three different neural network blocks called Parallel Segmenter, Cluster CNN, and Viability CNN that are trained for initial segmentation, cluster separation, and viability analysis. Parallel Segmenter and Cluster CNN blocks achieve accurate segmentation of individual cells while Viability CNN block performs viability classification. A modified U-Net network, a well-known deep neural network model for bioimage analysis, is used in Parallel Segmenter while LeNet-5 architecture and its modified version Opto-Net are used for Cluster CNN and Viability CNN, respectively. We train the Parallel Segmenter using 15 images of A2780 cells and 5 images of yeasts cells, containing, in total, 14742 individual cell images. Similarly, 6101 and 5900 A2780 cell images are employed for training Cluster CNN and Viability CNN models, respectively. 2514 individual A2780 cell images are used to test the overall segmentation performance of Parallel Segmenter combined with Cluster CNN, revealing high Precision/Recall/F1-Score values of 96.52%/96.45%/98.06%, respectively. Cell counting/viability performance of DeepCAN is tested with A2780 (2514 cells), A549 (601 cells), Colo (356 cells), and MDA-MB-231 (887 cells) cell images revealing high analysis accuracies of 96.76%/99.02%, 93.82%/95.93%, and 92.18%/97.90%, 85.32%/97.40%, respectively.

The aim of the study was to reveal the prevalence of concomitant endometriosis in malignant and borderline ovarian tumours. A retrospective analysis was performed of 530 patients with malignant ovarian tumours and 131 with borderline ovarian tumours, who underwent surgery in our hospital between 1995 and 2011. Forty-eight (7.3%) of 661 patients with malignant and borderline ovarian tumours were associated with endometriosis. Of the 48 endometriosis cases, 73% of those were atypical. Infertility was noted in 38% of patients with endometriosis-associated ovarian tumours. The most frequently endometriosis-associated subtypes were endometrioid (33%) and clear cell (18%) histologies. Of endometriosis-associated endometrioid and clear cell ovarian tumours, 70% were early stage and 60% were premenopausal. The prevalence of concomitant endometriosis in borderline tumours (12%) was found to be significantly higher than that found in the malignant ones (6%; p = .02). Of 32 endometriosis-associated malignant ovarian tumours, 69% were FIGO stages I and II. In conclusion, ovarian endometriosis is seen with both malignant and borderline ovarian tumours, the association being significant with borderline tumours. Fortunately, the endometriosis-associated malignant ovarian tumours are mostly early stage. Impact statement What is already known on this subject? Epidemiologic data suggest that endometriosis has malignant potential. However, a subgroup of women with endometriosis at a high risk for ovarian cancer is yet to be clarified. Currently, endometriosis and ovarian cancer association does not seem to have a clinical implication. What do the results of this study add? The findings of this study revealed that nearly 75% of endometriosis-associated ovarian tumours were of atypical endometriosis. Half of endometriosis-associated ovarian tumour cases were of endometrioid/clear cell histology and 70% were early-stage. Endometriosis was significantly associated with borderline ovarian tumours and the endometriosis-associated malignant ovarian tumours were mostly early stage. What are the implications of these findings for clinical practice and/or further research? Additional studies need to be conducted to develop screening approaches for malignant transformation or an association in women with endometriosis. Till that time, a change of current clinical practices cannot be justified. However, counselling and treating women with endometriosis who are at high risk for cancer coexistence or conversion is encouraged.

Aim: Malignant transformation of mature cystic teratoma (MCT) is an uncommon complication. Preoperative diagnosis is difficult because of the lack of specific symptoms and signs indicating malignancy. Thus, we retrospectively analyzed the clinical characteristics of patients and the role of surgery in their management., Material and Methods: During a 9-year period (2002-2010), six patients with malignant transformation arising from ovarian MCT were treated at the Gynecologic Oncology Unit of Bakirkoy Woman and Children's Training and Research Hospital. A retrospective chart review and analysis of the patients' data were conducted., Results: Malignant transformation arising from ovarian MCT accounted for 1.9% of all ovarian MCT (6/321). Three cases were stage IA and the other three were stage IC. Histologically, three of six cases had squamous cell carcinoma (50%), two had a carcinoid tumor (33%), and one had mucinous adenocarcinoma (17%). All patients underwent comprehensive surgical staging. Two patients received adjuvant chemotherapy and one received adjuvant chemoradiation. Five of six patients were observed for 16-104 months and no recurrence was detected. One patient with a carcinoid tumor in stage IC died of disease within 34 months following the surgery., Conclusion: Early detection of malignant transformation arising from MCT is mandatory for treating patients, but in most patients malignancy was detected intraoperatively. Surgical cytoreduction with a complete staging procedure and adjuvant treatment may be reasonable for stage IC. Additionally, prognosis is better when the tumor is completely excised and does not extend beyond the capsule., (© 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.)

The Brenner tumor is an uncommon ovarian tumor in pregnancy with only three previous cases in the English published reports. A 35-year-old woman delivered abdominally because of distress symptoms and a Brenner tumor was resected incidentally. Histological examination revealed a tumor composed of epithelial nests and areas of stromal luteinization. The patient was treated conservatively. Brenner tumor should be considered in the differential diagnosis of adnexal masses during pregnancy. These tumors are mainly benign and show typical luteinization associated with the hormonal milieu in pregnancy.

We report a rare case of a giant ovarian tumor presenting as an incarcerated umbilical hernia. A 61-yr-old woman was admitted to the hospital with severe abdominal pain, an umbilical mass, nausea and vomiting. On examination, a large, irreducible umbilical hernia was found. The woman underwent an urgent operation for a possible strangulated hernia. A large, multilocular tumor was found. The tumor was excised, and a total abdominal hysterectomy and bilateral salphingo-oophorectomy were performed. The woman was discharged 6 days after her admission. This is the first report of incarcerated umbilical hernia containing a giant ovarian tumor within the sac.

A case of 36-year-old nonmarried virgin woman presenting a giant ovarian serous cyst adenoma weighing 9.5 kg is reported here. Ovarian neoplasms may be divided by origin cell type into three main groups: epithelial, stromal and germ cell. Taken as a group, the epithelial tumors are by far the most common type. The single most common benign ovarian neoplasm is the benign cystic teratoma; however, according to some studies it is serous cyst adenoma. A 36-year-old nonmarried virgin woman was referred to our clinic from a local medical center. When she was seen first at our outpatient clinic, she looked like a 9-month pregnant woman. Her medical history was normal. She had no serious illness or operation before. On abdominal ultrasound, a giant cyst was found which encompassed the whole abdomen. At laparotomy, a giant, totally cystic, vascularized and smooth mass attached to the right ovary was encountered, lying between the symphysis and the xiphoid. Ooferectomy was performed. On the postoperative second day, she was discharged without any problem. Her pathology report disclosed a 35 x 20 x 16 cm(3) serous cyst adenoma weighing 9.5 kg. This is the largest ovarian cyst that ever reported from our hospital and one of the largest among the reported cases in the literature.

Background: Hemangiomas are very rare tumors of the ovary. Here, we report a case of a mixed capillary and cavernous ovarian hemangioma and endometrial carcinoma presenting with postmenopausal bleeding, male pattern receding frontal hairline, and high serum androgen and estradiol levels., Case: A 70-year-old White female underwent laparotomy for endometrial carcinoma. Intraoperative frozen-section examination of the uterus revealed a 3.5 x 3 cm, grade 1 endometrioid adenocarcinoma of the endometrium with more than 50% myometrial invasion. The left ovary contained a 1.5 x 1 x 1 cm, well-circumscribed hemorrhagic nodule on the cut surface. Final histopathological examination of the small nodule demonstrated multiple, enlarged, blood-filled vascular channels lined by a single layer of flattened regular endothelial cells with no atypical features. Vascular spaces within the tumor were of different sizes, ranging from small to large, and were separated by connective tissue. The surrounding ovarian stroma was hyperplastic and contained clusters of luteinized stromal cells. Microscopy of the right ovary showed minimal stromal proliferation and no luteinization of the ovarian stroma., Conclusion: This is the first case of an ovarian hemangioma synchronous with a well-differentiated endometrial carcinoma. Absence of estrogen and progesterone receptors in the endothelial cells of the hemangioma suggests that ovarian hemangiomas may occur independent of stimulation by estrogen and progesterone.