Ovarian carcinoma is the most common cause of death from a gynecologic malignancy. The most important prognostic factors are the presence and magnitude of residual or recurrent disease after therapy. Recurrent ovarian malignancy usually manifests as pelvic masses in the surgical bed, peritoneal seeding, nodal recurrence and pleuropulmonary lesions, and liver metastasis. Pelvic recurrence involves the vaginal stump, parametria, urinary bladder, and/or bowel adjacent to the surgical bed. Peritoneal seeding presents as nodules on the peritoneal surface, most commonly around the liver or cul-de-sac, and mesenteric infiltration. Pseudomyxoma peritonei is the other form of peritoneal seeding. Nodal recurrence appears as enlarged paraaortic nodes, especially at the renal hilar level. Unusual manifestations include metastasis in the extrahepatic abdominal solid organs, bone metastasis, and abdominal wall lesion involving subcutaneous fat or muscle. Familiarity with the patterns and spectrum of imaging findings of recurrent ovarian malignancy will facilitate accurate diagnosis and prompt treatment.

Abdominal Neoplasms↗

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Common bile duct and gallbladder varices.

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Adult↗

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Phosphorylation of potato starch and its electrorheological suspension.

Highly substituted potato starch phosphate (HPSP) particles were synthesized via an esterification process of potato starch with a mixture of several different concentrations of disodium hydrogen phosphate and sodium hydrogen phosphate. These particles were characterized via thermogravimetric analysis, scanning electron microscope, and inductively coupled plasma mass spectrometer. The electrorheological (ER) fluid was prepared by dispersing these HPSP particles in nonconducting silicone oil, and their ER properties were investigated. The HPSP particle-based ER fluid exhibited typical ER responses with a nonzero yield stress under an applied electric field. We examined the yield stresses for the potato starch-based anhydrous ER system by varying the degree of phosphate substitution and found that the higher polarization induced by the external electric field strength resulted in the higher values of yield stresses and shear stresses.

Carbohydrate Conformation↗

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Multinucleation of koilocytes is actually multilobation.

In order to clarify the complete cytomorphology of cytopathic changes as a consequence of human papillomavirus (HPV) infection, we performed three-dimensional (3D) reconstruction from confocal fluorescent images. After confirming 22 HPV types using a DNA chip, we performed 3D confocal image restoration in human uterine cervical swab samples and corresponding tumor tissues. On restoration of 3D confocal images, the multinucleated feature of koilocytes was revealed to be multilobation of a single nucleus, as opposed to true multinucleation.

Cell Nucleus↗

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Tumor angiogenesis as a prognostic predictor in colorectal carcinoma with special reference to mode of metastasis and recurrence.

Tumor angiogenesis has proved to be a useful prognostic determinant for patients with various solid tumors. In this study, we investigated the quantitative expression of angiogenesis in colorectal carcinoma to determine how angiogenesis correlates with clinicopathologic factors and prognosis. One hundred twenty-seven specimens resected from patients with primary colorectal carcinoma were investigated immunohistochemically using a polyclonal antibody against factor-VIII-related antigen, and areas with the highest vascular density at the invasive tumor margin were counted at 200 times magnification. The microvessel count, defined as angiogenesis density (AD), became significantly higher with increase in histologic grade (p = 0.02) and Dukes stage (p = 0.001). AD was also significantly higher in patients with lymph node metastasis (p = 0. 005), lymphatic invasion (p = 0.042), vascular invasion (p < 0.001), and liver metastasis (p = 0.0004) than in those without. In addition, patients with synchronous distant hematogenous metastasis in stage D disease showed significantly higher AD than patients with nonhematogenous metastasis (p = 0.006). When 27 cases of disease recurrence after surgical resection with curative intent were stratified according to mode of spread, AD in cases with a hematogenous pattern of relapse proved to be significantly higher than in cases with nonhematogenous spread (p < 0.001). No significant differences were, however, found in AD when they were subdivided as to operative nodal status (p = 0.39 and 0.08 in the node-negative and the node-positive group, respectively). Multivariate analysis indicated that AD was an independent prognostic factor (p = 0.0004) in colorectal carcinoma. Quantitative evaluation of tumor angiogenesis at the invasive tumor margin is suggested to be a good prognostic indicator and a useful predictor for hematogenous spread and recurrence in patients with colorectal carcinoma.

Colorectal Neoplasms↗

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Plasma choline concentrations in children requiring long-term home parenteral nutrition: a case control study.

BACKGROUND: Low plasma free choline concentration has been associated with elevated serum hepatic aminotransferase concentrations and hepatic steatosis in adults who need home parenteral nutrition (HPN). We sought to determine if plasma free choline is similarly reduced in children who need home total parenteral nutrition (TPN). METHODS: We compared the plasma free choline concentration in 21 children who required long-term HPN with 31 normal controls. Patients had received HPN for 75 +/- 13 (SD) months (range 3-206 months). All control children ingested a normal, mixed, nonvegetarian diet. RESULTS: The mean plasma free choline concentration in the children receiving HPN was significantly lower than normal children (6.6 +/- 4.3 vs 8.0 +/- 2.3 nmol/mL, p = .002). Plasma free choline concentration was correlated with age (r = -0.43, p = .049). Using multiple linear regression analysis for age, sex, and squared age (considered in order to account for possible nonlinearity between choline and age), HPN children showed a steady and significant decline in plasma free choline concentration with increased age at the rate of 0.03 nmol/mL per month. Plasma lipid bound choline concentration did not vary with age. No relationship was seen between either plasma free and lipid bound choline concentration and amount of daily IV lipid infusion. A significant negative correlation was observed between plasma free choline concentration and aspartate aminotransferase (AST) and alanine aminostransferase (ALT) (r = -0.72, p = .04 and r = -0.80, p = .02, respectively). CONCLUSION: Our data support the notion that patients who need long-term HPN without significant enteral feeding have a significant risk for the development of choline deficiency with its associated hepatic dysfunction.

Adolescent↗

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Cryopreservation of Taxus chinensis suspension cell cultures.

A simple cryopreservation method for suspension cells of Taxus chinensis was established. In this procedure 7 days old suspension cells were used without any pre-culture treatment. At first, cells were incubated in cryoprotectant solution (0.5M DMSO and 0.5M glycerol) on ice for 30 min and then frozen at a cooling rate of 1 degree C/min to -40 degrees C prior to immersion in liquid nitrogen. The average viability of frozen-thawed cells was between 30 to 40%. The recovery of cryopreserved cells in liquid nitrogen for 1 month was accomplished. After rapid thawing, cells were transferred to solid medium and cultivated for 4-6 weeks. The treatment of trehalose as a cryoprotectant enhanced re-growth of frozen-thawed cells. The stable maintenance of paclitaxel biosynthetic ability in cryopreserved cells was confirmed by comparing with that of regularly sub-cultured suspension cells.

Cell Survival↗

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Pediatric Wilson's disease: presentation and management.

Eleven patients (4 males, 7 females) with Wilson's disease who presented before 18 years of age are described. The mean age onset of symptoms was 11.2 +/- 3.9 (SD) years. The mean age at diagnosis was 13.3 +/- 3.4 (SD) years. All patients had hepatic manifestations of the disease when diagnosed: cirrhosis (6 patients), chronic hepatitis (2) and fulminant hepatic failure (3). Three patients were asymptomatic at diagnosis. Two of the symptomatic patients presented with new undescribed manifestations: one with blurred vision and the other with acalculous cholecystitis. At diagnosis, 6 patients had Kayser Fleischer rings and 5 had hemolytic anemia. The three patients with fulminant hepatic failure had hemolysis with relatively low serum aminotransferase and alkaline phosphatase levels, possibly helpful findings for rapid diagnosis of Wilson's disease in such presentation. Ten patients were treated with penicillamine. Liver transplantation was performed in 4 patients, 2 of which presented with fulminant hepatic failure. One patient died while waiting for liver transplantation, the remainder of the patients live free of symptoms. It is important to be aware of the different manifestations of Wilson's disease in the pediatric population, in order to make appropriate evaluations in a timely manner to facilitate early diagnosis and appropriate treatment.

Adolescent↗