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Drying-induced cracks in tablet coatings are undesirable as they not only affect tablet's appearance, but they may also interfere with its function. While it is well known that tensile stresses in the coating are responsible for coating failures, few have measured the stress in tablet coatings, especially when exposed to rapid environmental changes. In this study, two commercial tablet coatings based on Hydroxy Propyl Methyl Cellulose (HPMC) and Poly Vinyl Alcohol (PVA) are exposed to rapid variations in temperature and humidity to observe the variation in residual stress. Reducing temperature at a fixed humidity or reducing humidity at fixed temperature, both lead to high residual stresses. When both the humidity and temperature were reduced together, the residual stresses were very high causing delamination in the PVA-based film and cracking in the HPMC-based film. The changes in residual stress are almost instantaneous for the HPMC-based film while it is slower for the PVA-based film. The results highlight the importance of environmental conditions on the residual stress in the film and the resulting coating failure.

Endometrial stromal sarcomas (ESSs) are a rare form of uterine malignancy representing

The phenomenon of calcium alginate gel formation from sodium alginate drop impact on calcium chloride liquid pool generates enormous scientific interest. The present work features on the investigation of interfacial heat transfer during sodium alginate drop impact on a heated calcium chloride liquid pool. The liquid pool has been heated at different temperatures varying from 20 °C to 70 °C. The drop chemically reacts at the interface and calcium alginate gel starts to form which has been instantaneously captured in a high-speed camera. A mathematical model on crater dynamics has been presented to determine the heat transfer coefficient and amount of interfacial heat transfer during the chemical reaction. Now, drop levitation over the vapour layer generated from the evaporation of liquid pool is defined as Leidenfrost pool Effect. This is characterized from the heat transfer at the crater initiation stage and accumulated vapour layer thickness, vapour pressure developed. The release of drop liquid is aided by the surface tension difference between drop and pool at the interface and it is defined as thermal Marangoni Effect. It has been characterized from the variation of Marangoni pressure with temperature which tends to drain away accumulated vapour layer. A critical liquid pool temperature has been obtained when Leidenfrost vapour pressure dominates over Marangoni pressure and resists the drop release during the gel initial regime. The dynamics of calcium alginate gelation is governed by intricate interplay between thermal Marangoni effect and Leidenfrost pool effect with its effect on initial gelation time and total gelation time.

Objective To determine the accuracy of interpretation of a non-contrast MRI protocol in characterizing adnexal masses. Methods and materials Two hundred ninety-one patients (350 adnexal masses) who underwent gynecological MRI at our institution between the 1st of January 2008 and the 31st of December 2018 were reviewed. A random subset (102 patients with 121 masses) was chosen to evaluate the reproducibility and repeatability of readers’ assessments. Readers evaluated non-contrast MRI scans retrospectively, assigned a 5-point score for the risk of malignancy and gave a specific diagnosis. The reference standard for the diagnosis was histopathology or at least one-year imaging follow-up. Diagnostic accuracy of the non-contrast MRI score was calculated. Inter- and intra-reader agreement was analyzed with Cohen’s kappa statistics. Results There were 53/350 (15.1%) malignant lesions in the whole cohort and 20/121 (16.5%) malignant lesions in the random subset. Good agreement between readers was found for the non-contrast MRI score (к = 0.73, 95% confidence interval [CI] 0.58–0.86) whilst the intra-reader agreement was excellent (к = 0.81, 95% CI 0.70–0.88). The non-contrast MRI score value of ≥ 4 was associated with malignancy with a sensitivity of 84.9%, a specificity of 95.9%, an accuracy of 94.2% and a positive likelihood ratio of 21 (area under the receiver operating curve 0.93, 95% CI 0.90–0.96). Conclusion Adnexal mass characterization on MRI without the administration of contrast medium has a high accuracy and excellent inter- and intra-reader agreement. Our results suggest that non-contrast studies may offer a reasonable diagnostic alternative when the administration of intravenous contrast medium is not possible. Key Points • A non-contrast pelvic MRI protocol may allow the characterization of adnexal masses with high accuracy. • The non-contrast MRI score may be used in clinical practice for differentiating benign from malignant adnexal lesions when the lack of intravenous contrast medium precludes analysis with the O–RADS MRI score.

AIM: To determine the incidence of cervical cancer in women referred through the 2-week-wait pathway for postcoital bleeding and abnormal appearance of the cervix. METHODS: A retrospective cohort study was conducted of women with postcoital bleeding, or abnormal appearance of the cervix referred to colposcopy clinics through the 2-week-wait pathway for suspected cervical cancer at Cambridge University Hospitals in the United Kingdom over 5 years. Women were identified from a departmental database. Clinical and demographic data were collected. Categorical data was analyzed with chi-squared or Fisher's exact tests and predictive values were calculated. RESULTS: Of the 604 women referred, 1.16% were diagnosed with cervical cancer. None of the women who were up-to-date with cervical screening were diagnosed with cervical cancer, while 6.25% of women out-of-date with cervical screening or outside the screening age group were diagnosed with cervical cancer (p < 0.001). The positive predictive value for diagnosing cervical cancer was 1.70% for postcoital bleeding (95% confidence interval [CI] 0.64-3.7) and 0.31% for abnormal appearance of the cervix (95% CI 0.0008-1.7). CONCLUSIONS: The incidence of cervical cancer in women referred through the 2-week-wait pathway for postcoital bleeding and abnormal appearance of the cervix is low. These referrals have considerable implications for both patients and clinicians, and have a low predictive value for diagnosing cervical cancer. In light of emerging evidence and changing practices, referral guidelines should be reviewed based on up-to-date data and current practices.

Vulval cancer is a rare gynaecological cancer, predominantly seen in postmenopausal women. It accounts for about 4% of gynaecological malignancies. Most women present with vulval symptoms such as a painful lump, ulcer or itching, although some women may be asymptomatic. It is best managed in experienced cancer centres where relevant expertize and experience is available to provide multidisciplinary, individualized care for these women. The majority of vulval cancers are squamous cell cancers. Wide local excision of the lesion, usually with surgical staging of groin nodes, through separate incisions is recommended for early disease. Locally advanced vulval cancers require complex and highly individualized treatment, which may be a combination of radical excision with reconstruction with or without radiotherapy. Sentinel lymph node dissection is now becoming a standard of care instead of en-bloc inguino-femoral lymphadenectomy for surgical staging of smaller, early stage tumours. Radiotherapy is often required as adjuvant treatment following surgery, or for treatment of recurrent disease.

The genomic complexity and heterogeneity of high-grade serous ovarian cancer (HGSOC) has hampered the realisation of successful therapies and effective personalised treatment is an unmet clinical need. Here we show that primary HGSOC spheroid models can be used to predict drug response and use them to demonstrate that somatic copy number alterations (SCNAs) in frequently amplified HGSOC cancer genes significantly correlate with gene expression and drug response. These genes are often located in areas of the genome with frequent clonal SCNAs. MYC chromosomal copy number is associated with ex-vivo and clinical response to paclitaxel and ex-vivo response to mTORC1/2 inhibition. Activation of the mTOR survival pathway in the context to MYC-amplified HGSOC is mostly due to increased prevalence of SCNAs in genes from the PI3K pathway. These results suggest that SCNAs encompassing driver genes could be used to inform therapeutic response in the context of clinical trials testing personalised medicines.

An instantaneous chemical reaction and solidification have been experimentally explored during sodium alginate drop impact on calcium chloride liquid pool through a high-speed imaging system. Here, different concentrations of sodium alginate are used to study the effect on gelation process. As soon as the alginate drop touches the calcium chloride pool, a crosslinking polymerization reaction starts under the liquid pool surface. The consequence of crosslinking is rapid formation of calcium alginate gel which denotes instantaneous freezing of liquid drop. The drop impact solidification immediately results in the formation of a strong gel layer in front of it which is having significant role in spherical shape recovery. This layer formation is favoured by increasing sodium alginate concentration in the drop and thus crater growth is hindered also. The initial reaction time which is determined as soon as the drop touches the surface, is found to be dependent on the drop kinetic energy. However, the drop gelation time reduces with drop concentration and it controls the final shape and morphology of gel. Such reduction in gelation time is inferred from the enhanced rate of crosslinking reaction. The motion of liquid drop through liquid pool while interacting with the surroundings influences the drag around the spherical drop. The shape evolution in the solidifying gel is governed by the dynamics between the fluid drag and chemical reaction. The morphology of the gel surface has also been studied and its roughness variation has been measured from fractal box counting method.

Coupled effects of hydrodynamics and chemical reaction during gelation process have been studied in the current work. Here, a viscous sodium alginate liquid drop impacts on calcium chloride liquid pool, chemically reacts with the pool, forms a crater, and instantaneously changes its phase from liquid to soft solid called as gel. The drop impingement height and liquid pool concentration are varied to study the effect on this process. This phenomenon is captured in a time resolved high-speed camera and the dynamics of the crater is traced using image processing technique. We also use a mathematical model for crater growth which we assume to be influenced by the rate of gelation. By validating the theoretical trend with the experimental counterpart, the gelation energy has been obtained. Scaling analysis has been executed to determine significant contributory energy in the crater growth. It is also observed that the gel swelling occurs beyond a critical concentration of calcium chloride. Also, the effect of gelation on the homogeneity and strength of alginate gel are interpreted from the surface morphology examination in scanning electron microscope. Thus a new insight of gelation process has been elucidated from the context of fluid dynamics.

In the UK, more than 3,200 new cases of cervical cancer are diagnosed each year. Early stage cervical cancer (IA2-IB1) treatment comprises central surgery mainly in the form of radical hysterectomy or fertility sparing surgery including trachelectomy as well as systematic pelvic lymphadenectomy to detect metastases and adjust treatment accordingly. Given the variation in determining the lymph node (LN) status, a major prognosticator, we reviewed the current UK practice of LN assessment in women undergoing surgery for early cervical cancer. A 7-question, web-based survey, screened by the BGCS committee, was circulated amongst BGCS members. The overall response rate was 51%. Only 12.5% of the respondents routinely performed frozen section examination (FSE); the main reasons for not doing FSE were the pressure on theatre time (54.5%) and the lack of available facilities (48.5%). When positive pelvic nodal disease was detected, in 21 out of 50 (42%) the planned radical hysterectomy (RH) was aborted. More than 70% of the respondents routinely performed RH without any prior resort to pelvic lymphadenectomy. Pretreatment surgical para-aortic LN assessment was performed by 20% of the respondents. The survey confirms the diversity of the UK practice patterns in the surgical treatment of early cervical cancer.

Synthesis of pristine Cu–Al layered double hydroxide (LDH) nanofluid via one step method and study of its thermal properties are the core essence of the current work. Nitrate salts of Cu, Al and Na were mixed in a particular molar ratio at constant pH to produce desired Cu–Al LDH. Different dispersion techniques were utilized to uniformly disperse Cu-Al LDH in water to obtain Cu–Al LDH nanofluids. Broadly used characterization techniques were implemented to identify and characterize pristine Cu–Al LDH nanoparticle. These techniques were used to determine crystallite size, composition, morphology and characteristics vibration of interlayer anion present in the nanoparticle. The nanofluids were characterized for particle size, cluster size, surface tension and thermal conductivity. Particle size analysis was carried out to confirm the formation of nanofluid. Dynamic light scattering (DLS) method had been employed to measure the clustering tendency of nanofluid. Effect of nanofluid loading on thermal conductivity was studied in depth. Influence of particle size, shape and composition on thermal conductivity of nanofluid had also been selected as an essential topic of investigation. Zeta potential and visual phase separation study were carried out to measure the stability of concerned nanofluid.

Air-atomized spray cooling of a hot moving AISI 304 steel plate of 6 mm thickness has been investigated experimentally by varying water flow rate and plate velocity at a fixed nozzle-to-plate distance. It is found that the heat transfer coefficient is a non-linear function of surface temperature. The result shows that the cooling rate increases with an increase in the water flow rate. The highest cooling rate has been found for the static plate, whereas for a moving plate, an increasing cooling rate trend has been observed with increasing plate velocity.

The objective of this work is to study the chemical reaction between sodium alginate drop and calcium chloride film and instantaneous formation of calcium alginate gel. The complexity of this work is the simultaneous effect of both liquid and solid surface on drop impact gelation process. The sodium alginate concentration in the drop fluid, liquid film thickness, and drop impingement height are varied and the observations are captured using a high speed camera. Several interesting phenomena like splashing and jet break up occur depending on the drop impingement velocity, drop concentration, and film thickness. Crosslinking reaction and mixing mechanisms are schematically explained accounting the role of capillary wave propagation within the liquid film. A mathematical model on drop spreading on the solid surface after penetrating the liquid film is developed to predict the theoretical gel length for ultrathin and thin film regimes. Maximum spreading diameter of the drop postimpact on the liquid film is predicted from the model. However, the experimentally measured solidified gel length deviates from the theoretical values and these deviations are utilized to measure the rate of crosslinking gelation and instantaneous solidification. Different hydrodynamic parameters such as the crater depth, crater contact time, and crater dissipation energy are evaluated for the dynamics of gelation. Finally, the kinetics of gelation with the variation of liquid film thickness are determined for alginate drop concentrations and drop impingement heights.

ObjectiveIn early-stage cervical cancer, single modality therapy is the main objective, to minimize patient morbidity while offering equivalent cure rates. Intraoperative frozen section examination (FSE) of lymph nodes (LNs) can facilitate this aim, ensuring that radical surgery is avoided in patients requiring adjuvant therapy for metastatic LN involvement. We aimed to evaluate the accuracy of routine intraoperative FSE of pelvic LNs during the surgical staging of early-stage cervical cancers and identify a group at low risk for nodal metastases.MethodsA retrospective cohort study of 94 women aged 23 to 80 years who underwent primary surgery and planned intraoperative FSE of the pelvic LNs at the gynecological cancer center in Oxford was performed. The diagnostic value of FSE and the prediction of metastatic nodal disease were assessed by use of preoperative and intraoperative variables.ResultsA total of 1825 LNs were submitted for FSE. Of 94 women (13.8%), 13 had positive LNs at FSE. Two false-negative cases were reported with micrometastases but no false-positive cases. Frozen section examination as a diagnostic test reached a sensitivity of 86.7% and a specificity of 100%. A regression model including grade I to II and tumor size of less than 20 mm identified a low-risk group for LN involvement.ConclusionsIn light of diverse practice patterns, FSE should be routinely offered to women with early-stage cervical cancer in a 1-step protocol. We equally devised a model to predict those patients at least risk of nodal disease, who may be spared of FSE.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety of adjuvant radiotherapy for women with vulval cancer.

Yolk sac tumors (YSTs) with a somatic glandular pattern can be difficult to recognize histologically because they reproduce developing intestinal, hepatic, or lung tissue and can express markers such as CDX2 and TTF1. We report an unusual case of a primary endometrial YST showing florid endodermal-intestinal differentiation in a 63-yr-old woman with a history of colorectal adenocarcinoma. Histologically, the tumor exhibited a glandular and papillary architecture and showed widespread immunoreactivity for CDX2 and focal staining for CK20 and CEA, mimicking metastatic colorectal carcinoma on biopsy. The presence of subnuclear cytoplasmic clearing and positive staining for germ cell markers, however, pointed toward a diagnosis of primary endometrial YST, and this was supported by the radiologic and the subsequent pathologic finding of a primary endometrial-based lesion. YSTs in this age group usually arise in association with somatic tumors and in this case a small focus of coexistent endometrioid adenocarcinoma was identified within the uterus. Despite surgery and adjuvant chemotherapy, the patient showed disease progression with liver and lung metastases 6 mo postoperatively.

Background Sentinel Lymph Node (SLN) sampling may significantly reduce surgical morbidity by avoiding needless radical lymphadenectomy. In gynaecological cancers, the current practice in the UK is testing the accuracy of SLN detection using radioactive isotopes within the context of clinical trials. However, radioactive tracers pose significant logistic problems. We, therefore, conducted a pilot, observational study to assess the feasibility of a novel optical imaging device for SLN detection in gynaecological cancers using near infrared (NIR) fluorescence. Methods A novel, custom-made, optical imaging system was developed to enable detection of multiple fluorescence dyes and allow simultaneous bright-field imaging during open surgery and laparoscopic procedures. We then evaluated the performance of the system in a prospective study of 49 women with early stage vulval, cervical and endometrial cancer who were scheduled to undergo complete lymphadenectomy. Clinically approved fluorescent contrast agents indocyanine green (ICG) and methylene blue (MB) were used. The main outcomes of the study included SLN mapping detection rates, false negative rates using the NIR fluorescence technique and safety of the procedures. We also examined the association between injection sites and differential lymphatic drainage in women with endometrial cancer by fluorescence imaging of ICG and MB. Results A total of 64 SLNs were detected during both open surgery and laparoscopy. Following dose optimisation and the learning phase, SLN detection rate approached 100 % for all cancer types with no false negatives detected. Fluorescence from ICG and MB detected para-aortic SLNs in women with endometrial cancer following uterine injection. Percutaneous SLN detection was also achieved in most women with vulval cancer. No adverse reactions associated with the use of either dyes were observed. Conclusions This study demonstrated the successful clinical application of a novel NIR fluorescence imaging system for SLN detection across different gynaecological cancers. We showcased the first in human imaging, during the same procedure, of two fluorescence dyes in women with endometrial cancer. Electronic supplementary material The online version of this article (doi:10.1186/s13104-015-1576-z) contains supplementary material, which is available to authorized users.

Spray cooling is critical in many industrial applications to extract large heat fluxes from metal parts, such as hypervapotron in nuclear fusion reactors, heat treatment of steel plates in run-out table (ROT), electronic parts, and many more. The objective of the present study is to enhance the heat dissipation in transition and nucleate boiling regimes using an air-atomized water spray with water-based copper nanofluid as a coolant. The nanoparticle used in this study is energetic metal Cu, which has been prepared by mechanical milling (MM) process. The nanofluid has been prepared by suspending 0.1 vol. % Cu nanoparticles in water, with or without a dispersing agent (surfactant). The effect of type of dispersing agent on augmentation of boiling heat transfer has also been studied. The spray cooling experiments are conducted on a 6 mm thick stainless steel plate of initial temperature above 900 °C. The transient surface heat flux and temperatures are estimated using commercial inverse heat conduction software named intemp. The experimental results illustrated that transition and nucleate boiling heat flux as well as critical heat flux (CHF) increased significantly using nanofluid spray. A maximum ultrafast cooling (UFC) rate of 267 °C/s is achieved using surfactant-based nanofluid spray, which is 31.53% and 59.88% higher as compared to the nanofluid without any dispersant and pure water sprays, respectively. Overall, the surfactant-based copper nanofluid spray can serve as a better coolant on the ROT of steel processing industry.

Pelvic actinomycosis comprises a rare, subacute to chronic bacterial infection characterised by suppurative and granulomatous inflammation. Diagnosis is difficult as it may simulate pelvic malignancies. Laboratory and radiological findings are non-specific. We reported on 2 cases of pelvic actinomycosis mimicking ovarian malignancy with different management approaches that lead to opposite outcomes. We reviewed the literature on pelvic actinomycosis imitating ovarian cancer with a focus on its surgical management. Despite agreement on the duration of antibiotic therapy following surgical management, consensus regarding surgical approach was rather equivocal. We concluded that pelvic actinomycosis should be strongly suspected in women with presumed ovarian cancer of atypical presentation and a history of intrauterine devices (IUD). Electronic supplementary material The online version of this article (doi:10.1186/2053-6844-1-5) contains supplementary material, which is available to authorized users.

Background Pelvic irradiation is essential for improving survival in women with pelvic malignancies despite inducing permanent ovarian damage. Ovarian transposition can be performed in premenopausal women in an attempt to preserve ovarian function. As uncertainty occurs over the proportion of women who are likely to benefit from the procedure, we performed a systematic review and meta-analysis of the proportion of women with ovarian function preservation, symptomatic or asymptomatic ovarian cysts and metastatic ovarian malignancy following ovarian transposition. Methods Medline, Embase and The Cochrane Library databases were systematically searched for articles published from January 1980 to December 2013. We computed the summary proportions for ovarian function preservation, ovarian cyst formation and metastatic ovarian disease following ovarian transposition by random effects meta-analysis with meta-regression to explore for heterogeneity by type of radiotherapy. Results Twenty four articles reporting on 892 women undergoing ovarian transposition were included. In the surgery alone group, the proportion of women with preserved ovarian function was 90% (95% CI 92–99), 87% (95% CI 79–97) of women did not develop ovarian cysts and 100% (95% CI 90–111) did not suffer metastases to the transposed ovaries. In the brachytherapy (BR) ± surgery group, the proportion of women with preserved ovarian function was 94% (95% CI 79–111), 84% (95% CI 70–101) of women did not develop ovarian cysts and 100% (95% CI 85–118) did not suffer metastases to the transposed ovaries. In the external beam radiotherapy (EBRT) + surgery ± BR group, the proportion of women with preserved ovarian function was 65% (95% CI 56–74), 95% (95% CI 85–106) of women did not develop ovarian cysts and 100% (95% CI 90–112) did not suffer metastases to the transposed ovaries. Subgroup meta-analysis revealed transposition to the subcutaneous tissue being associated with higher ovarian cyst formation rate compared to the “traditional” transposition. Conclusion Ovarian transposition is associated with significant preservation of ovarian function and negligible risk for metastases to the transposed ovaries despite common incidence of ovarian cysts.

We describe the development and performance analysis of two clinical near-infrared fluorescence image-guided surgery (FIGS) devices that aim to overcome some of the limitations of current FIGS systems. The devices operate in a widefield-imaging mode and can work (1) in conjunction with a laparoscope, during minimally invasive surgery, and (2) as a hand-held, open surgery imaging system. In both cases, narrow-band excitation light, delivered at multiple wavelengths, is efficiently combined with white reflectance light. Light is delivered to ~100 cm2 surgical field at 1-2 mW/cm2 for white light and 3-7 mW/cm2 (depending on wavelength) of red - near infrared excitation, at a typical working distance of 350 mm for the hand-held device and 100 mm for the laparoscope. A single, sensitive, miniaturized color camera collects both fluorescence and white reflectance light. The use of a single imager eliminates image alignment and software overlay complexity. A novel filtering and illumination arrangement allows simultaneous detection of white reflectance and fluorescence emission from multiple dyes in real-time. We will present both fluorescence detection sensitivity modeling and practical performance data. We have demonstrated the efficiency and the advantages of the devices both pre-clinically and during live surgery on humans. Both the hand-held and the laparoscopic systems have proved to be reliable and beneficial in an ongoing clinical trial involving sentinel lymph node detection in gynecological cancers. We will show preliminary results using two clinically approved dyes, Methylene blue and indocyanine green. We anticipate that this technology can be integrated and routinely used in a larger variety of surgical procedures.

Objective: Outpatient hysteroscopy (OPH) is increasingly used as the first line investigation for perimenopausal and postmenopausal women with abnormal uterine bleeding. With high success and good pathology detection rates it has the advantage of allowing investigation and management of patients within a one-stop clinic set-up, resulting in high patient acceptability. Failure rates are low, however the main limitation is patient intolerance secondary to pain. Difficulties are thought to be for encountered in nulliparous or postmenopausal women though the evidence is sparse. The aim of this study was to assess which patient factors have an impact on the success of OPH. Design: Prospective observational study Material and methods: The study was carried out from September 2012 to March 2013 in the outpatient hysteroscopy clinic at John Radcliffe Hospital, Oxford. All 96 patients in this series had their OPH performed by the same operator, using only a complete vaginoscopic approach. We used binary logistic regression to analyse which factors had an effect. Results: No significant correlation was found between age and menopausal status. Our study suggested that parity by itself is not predictive but it did find a statistically significant link between previous mode vaginal mode of delivery and successful OPH (p-value=0.001). Conclusions: This paper enhances our understanding of relevant patient factors, which will be useful in facilitating more patient specific counselling. It should also ideally encourage further studies into strategies to improve the success rate of this invaluable diagnostic and therapeutic modality.

To review the outcomes of pelvic exenterative surgery done with a palliative intent and evaluate its role in relapsed gynaecology malignancies. This is a retrospective cohort study between April 2009 and May 2012 in Oxford Gynaecological Cancer Centre. Patients were identified from the oncology surgical database. 18 patients were identified with a mean age 54 (26–79) years, who underwent surgery for symptomatic recurrent cancer. All except one patient had radiotherapy prior to surgery. 12 patients had cervical cancer, five had vulval cancer and one had endometrial cancer. About half of the patients had major surgical complications; however, majority was patients satisfied with the outcome. Pelvic exenteration in this context carries considerable morbidity and in this series achieved good symptom control with a mean overall survival of 11 months. Careful patient selection, adequate counselling and ongoing support are imperative of successful outcome.

Objective To evaluate institutional experiences regarding laparoscopic salpingo-oophorectomy in breast cancer patients and to compare the technique with gonadotropin-releasing hormone (GnRH) analogs among premenopausal women with hormone-sensitive breast cancer. Methods Between 2004 and 2009, 103 women with breast cancer underwent laparoscopic salpingo-oophorectomy at Addenbrooke's Hospital, Cambridge, UK. All relevant medical records—including reasons for salpingo-oophorectomy, peri-operative events, and subsequent follow-up—were reviewed. Results In the study period, 3 (2.9%) women experienced a recurrence of breast cancer but none had primary peritoneal/ovarian cancer within a median follow-up interval of 34 months (range, 0–70 months). No operative complications were noted among these women and all of them went home on the day of their operation. Conclusion Laparoscopic salpingo-oophorectomy seems to be a safe, permanent, and cost-effective method of ovarian ablation compared with the use of GnRH analogs. Salpingo-oophorectomy also considerably reduces the risk of subsequent ovarian/fallopian tube malignancy in this high-risk population.

Background Ovarian cancer is the sixth most common cancer and seventh most common cause of cancer death in women world-wide.Three-quarters of women present when the disease has spread through-put the abdomen (stage III or IV) and treatment consists of a combination of debulking surgery and platinum-based chemotherapy, with or without taxanes. Although initial responses to chemotherapy are often good, most women will relapse and require further chemotherapy and will eventually develop resistance to chemotherapy agents. Increased understanding about the molecular basis of ovarian cancer has lead to the development of novel agents, which work in different ways to conventional chemotherapy. These include DNA-repair pathway inhibitors, the commonest of which are the PARP (poly (ADP-ribose) polymerase) inhibitors. It is therefore important to compare their effectiveness and side effects of these novel agents to assess their role in the treatment of advanced ovarian cancer, especially as treatment of advanced disease is aiming to improve length of survival and quality of life (QoL).

This is the protocol for a review and there is no abstract. The objectives are as follows: To compare the effectiveness and harmful effects of interventions, which target the epidermal growth factor receptor, in the treatment of ovarian cancer.

Background Aggressive angiomyxoma was identified as a distinct clinicopathologic entity in 1983 and since then fewer than 250 cases of these rare tumors have been reported in world literature. These tumors usually arise in the pelvis and perineal regions, most often in women of the reproductive age group; however a few cases of its occurrence outside the pelvis have also been reported. Patients and methods We report a series of 7 women treated in our institute in the last 8 years. Relevant literature on aggressive angiomyxoma was looked at and various management options reviewed. Conclusion Aggressive angiomyxomas are locally aggressive, notorious for local recurrence and extremely rare to metastasize. While surgery remains the mainstay of treatment, there has been a definite shift towards less radical forms of excision, over the years. Various adjuvant treatment modalities have also been tried to reduce tumor recurrence.

Mature cystic teratomas account for 30–45 % of all ovarian tumours. Malignant transformation of these tumours is rare with squamous cell carcinoma (SCC) being the commonest histological type. During a 24-year period (1986–2010) we identified six women treated for SCC arising in a mature cystic teratoma at our institution. Each case was reviewed retrospectively recording presenting symptoms, tumour markers, preoperative imaging, tumour stage, management and outcome. Durable responses are difficult to achieve but best treatment response was seen in a woman who had partial response to chemo-radiotherapy. Concurrent chemo-radiation may be considered for disease confined to the pelvis.