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PubMed2005

Microdissection-based mutational genotyping of serous borderline tumors of the ovary.

Mutational changes in a number of genetic foci were studied in 12 serous borderline tumors (SBTs) of the ovary including 2 with a micropapillary pattern. The analysis was focused on chromosomal regions that have not been previously studied in these tumors. The findings were correlated with the morphology and the FIGO stage of the tumors. Six of the tumors were stage I, one was stage II, and five were stage III. Loss of heterozygosity analysis in each tumor was performed with a panel of 12 polymorphic markers on chromosomes 1p, 5q, 9p, 9q, 10q, and 17p. The ovarian tumors displayed allelic losses most frequently on 1p (83.3%), 9q (70%), and 17p (41.7%). In the extraovarian implants, allelic losses on 1p, 9q, and 17p were present in 66.7%, 75%, and 66.7% of cases respectively. In five of six cases, allelic losses were 88% concordant between multiple tumor sites. Only one case of stage III tumor displayed a discordant pattern of allelic loss at different tumor sites. Cumulative allelic losses did not show a statistically significant difference in stage I vs. higher stage disease. The pattern and cumulative allelic loss in the two cases with micropapillary architecture was similar to that of the other tumors. We report a high frequency of allelic loss on 1p and 9q that has not been previously reported in SBTs. Morphologically heterogenous areas including benign-appearing, typical borderline, and micropapillary areas had a similar pattern of allelic loss. Although the majority of SBTs seem to be monoclonal, a minor subset may be multiclonal in origin.

Adult↗
PubMed2005

Fas and Fas ligand in cyst fluids, serum and tumors of patients with benign and (borderline) malignant ovarian tumors.

Drug resistance in ovarian cancer treatment urges the exploration of new targets for drugs against this malignancy. Fas is a cell membrane receptor which, after engagement with Fas ligand (FasL), triggers apoptotic death. In this study Fas and FasL levels in cyst fluids and sera of patients with benign, borderline and malignant ovarian tumors and in corresponding tumors are determined. Fas and FasL were determinded by ELISA and immunohistochemistry in 30 patients with benign, 5 patients with borderline and 24 patients with malignant epithelial ovarian tumors. In serum there were no differences in median Fas levels, while median FasL levels were higher in healthy women (p=0.02). In malignant cyst fluids, median Fas levels where higher compared to benign cyst fluids (p<0.01). FasL immunostaining was more frequent in malignant ovarian tumors (p=0.002). In conclusion, serum Fas or FasL levels do not seem useful markers. Elevated Fas and equal FasL levels in malignant cyst fluids, suggest an increased production of Fas, and not of FasL by malignant cells. High expression of both Fas and FasL, in malignant ovarian tumors present Fas/FasL as an interesting route to explore for innovative cancer therapy.

Blotting, Western↗
PubMed2005

Chromogenic in situ hybridization for the detection of HER-2/neu gene amplification in breast cancer with an emphasis on tumors with borderline and low-level amplification: does it measure up to fluorescence in situ hybridization?

We compared chromogenic in situ hybridization (CISH) with fluorescence in situ hybridization (FISH) for assessing HER-2/neu gene amplification using tissue microarrays (TMAs) made from formalin-fixed, paraffin-embedded tissue blocks from 113 cases of invasive breast carcinoma. TMAs were created using 0.6-mm tissue cores with 4 sampled cores per tumor. For both assays, a HER-2/chromosome 17 signal ratio of 2.0 or more was considered positive for gene amplification. The average ratio of cores from the same tumor was used for determination of gene amplification status of that particular tumor Of 113 cases, 102 were tested successfully by both assays. The results were concordant in 100.0% of cases (63 amplified; 39 nonamplified). All 22 cases of borderline (ratio, 2.0-2.5) or low-level (ratio, 2.6-3.9) amplification by FISH also showed HER-2 gene amplification by CISH. CISH is as sensitive as FISH in detecting borderline and low-level HER-2 amplification. Reliable recognition of the invasive carcinoma area by light microscopy and preservation of the test slides are added advantages of CISH. CISH performs as well as FISH in the analysis of HER-2 gene amplification in breast cancer and might have advantages in certain situations.

Breast Neoplasms↗
PubMedDate not supplied

Measurement of glycodelin A in fluids of benign ovarian cysts, borderline tumours and malignant ovarian cancer.

BACKGROUND: Glycodelin A levels in fluids of benign ovarian cysts, borderline tumours and ovarian cancer, as well as serum-levels of glycodelin A, were analysed in patients with benign and malignant ovarian tumours. The aim of the study was to investigate if the level of glycodelin A in body fluids of patients with malignant ovarian tumours could be a marker for the disease. Additionally, immunohistochemical investigations of glycodelin A expression in tissue of ovarian cancer were performed. MATERIALS AND METHODS: A total of 158 samples of fluids from benign ovarian cysts, borderline tumours and ovarian cancer were collected during surgery in the Department of Obstetrics and Gynaecology at the University of Rostock, Germany. Additionally, 69 samples of serum from patients with benign ovarian cysts and ovarian cancer on the day before surgery were collected. An ELISA for determination of glycodelin A was used. Immunohistochemical detection of glycodelin A expression was performed on ovarian cancer tissue from 38 patients. RESULTS: Malignant cystic fluids showed higher glycodelin A values (mean: 1814.4 ng/ml) compared to fluids of benign ovarian cysts (mean: 784.4 ng/ml). The results of glycodelin A determination were compared using the Mann- Whitney U-test for comparison of the means. There was a statistically significant difference between benign ovarian cysts and malignant ovarian cancer for the fluid (p <0.001). In addition, serum samples of malignant ovarian tumours also showed significantly higher glycodelin A values compared to serum levels of benign tumours (p<0.001). Immunohistochemical staining on ovarian cancer tissue showed a glycodelin A expression in 25-30% of the carcinoma cells. CONCLUSION: High levels of glycodelin A were found in cystic fluids of ovarian cancer. In addition, we also found higher levels of glycodelin A in the serum of patients with ovarian cancer compared to the serum of patients with benign ovarian cysts. Furthermore, ovarian cancer tissues showed intense staining with a glycodelin A antibody. Further investigations are necessary to show if glycodelin A quantification could help to diagnose ovarian cancer.

Body Fluids↗
PubMed2005

Serous borderline ovarian tumors: where are we now?

In the present article we report the revised microscopical features of serous borderline ovarian tumors (S-BOTs) in the context of a long personal experience, drawing parallels with the definitions and issues elaborated at the Borderline Ovarian Tumor Workshop held in August 2003 in Bethesda. In our opinion none of the histopathologic criteria of the primary tumor including micropapillary subtype of the S-BOT can be used yet as a prognostic marker. The most realistic assumption is that in the clinical course of the S-BOT dynamic transformation of different clones occurs and the process develops simultaneously with multicentric blastomogenesis in the peritoneal cavity. Hence the failure of our efforts to forecast the prognosis of the disease using the microscopical structure of the primary tumor as a point of issue. It is indispensable to control the course of the S-BOTs by performing repeated biopsies at each relapse and modify the treatment schedules according to the microscopic patterns revealed at a given stage of the disease. Relapses of the S-BOTS may occur up to 50 years later so the patient should be under surveillance especially by a urologist to detect the earliest symptoms of urinary tract obstruction. Much more attention should be paid to the local intraabdominal administration of drugs and the search for new systemic chemotherapy regimens.

Cysts↗
PubMed2005

Breast cancer and borderline ovarian carcinoma in young patients--case report.

Cystosarcoma phyloides is a breast cancer with deterrent features because of its size and fast growth. Borderline ovarian tumors comprise 10% to 15% of all epithelial tumors of the ovary. Regardless of the tumor type (serous, mucinous, clear cell, Brenner, mixed) they can be benign, borderline or malignant. There is a close physiological relation between the breasts and genital tract. By routine examination of girls in secondary schools, suspected ultrasonography findings were found in two out of 180 examinees.

Adolescent↗
PubMed1991

[Differentiated exercise therapy of patients with borderline forms of neuropsychological disorders].

The paper is concerned with an assay of the functions of the cardiovascular system, central nervous system, and neuromuscular apparatus in patients with borderline mental disorders. New approaches to administering different forms of exercise therapy have been defined bearing in mind the variant of the nervous system and the leading syndrome of a disease. The simplicity and safety of the method makes it possible to recommend that the method be widely used by physicians in carrying out physical rehabilitation of patients suffering from borderline mental disorders.

Blood Pressure↗
PubMed1991

[Clinico-psychopathological aspects of borderline mental disorders in infancy].

The authors summarize the data obtained during a comprehensive examination of 200 children of the first year of life with borderline mental disorders. Abnormalities of vegetative and instinctive regulation, psychomotor and affective disorders which are, as a rule, of the borderline nature, occupy the leading position in the structure of the above-indicated disorders. The latter ones are associated frequently enough with different types of development retardation and neurological deviations from normal. The signs of differentiating between these disorders and analogous ones within the framework of endogenous mental pathology are depicted. The role is demonstrated of etiological factors (perinatal encephalopathy, constitutional, psychosocial, disturbances of the mother-child system). The studies attest to the basic demonstrability of psychopathological abnormalities and to their great diversity in infants.

Autonomic Nervous System Diseases↗
PubMed2006

Recurrent endocervical-like mucinous borderline tumor (ELMBT) arising in a case of long-standing endometriosis--a case report.

Endometriosis is a well-known precursor lesion of ovarian malignancies, particularly those of endometrioid and clear-cell types and rarely of serous or mucinous types. The association of endometriosis with mucinous borderline tumors also varies. This case is of a 60 year old female, who had a long history of more than thirty years of endometriosis and developed recurrent endocervical-like mucinous borderline tumor (ELMBT) in endometriotic foci. This case highlights challenges in the management of such complications associated with endometriosis and emphasizes the importance of long-term follow-up in cases of endometriosis.

Cystadenoma, Mucinous↗
PubMed1990

Recognition of borderline carbohydrate-lipid metabolism disturbance: an incipient form of type IV hyperlipoproteinemia?

Blood glucose and insulin responses to oral glucose were measured in 33 men: 8 normal, 13 with borderline carbohydrate-lipid metabolism disturbance (BCLMD) (pre-beta-lipoproteinemia with normal cholesterol and triglyceride levels), and 12 with mild Type IV hyperlipoproteinemia. Average age was 30 years, and the percentage of ideal weight was 101%. Borderline patients exhibited hyperinsulinemia following oral glucose, notably at 30 min; they also demonstrated an apparent impairment in homeostatic control of blood glucose level, with a greater-than-normal decline in blood glucose in the 3- to 4-h period (by profile analysis). The Type IV patients, though of normal weight and adiposity, exhibited elevated late incremental insulin area (LIIA) (1-5 h) responses. Combining all data, fasting triglycerides correlated with LIIA (p = 0.0002); LIIA correlated with the percentage of adipose mass (p = 0.003), suggesting that LIIA reflects insulin resistance. Lipoprotein electrophoresis remains useful for detecting pre-beta-lipoproteinemia, which may occur even in persons with normal cholesterol and triglyceride levels. When present, it suggests the possibility of hyperinsulinemia following glucose ingestion, which in turn has been shown to be an independent predictor for the development of coronary heart disease. To gain increased understanding of the natural history of hypertriglyceridemia, persons with BCLMD should be studied separately from those with normal lipid and carbohydrate metabolism and from those with hypertriglyceridemia.

Adult↗
PubMed2006

Serous cystadenoma of borderline malignancy arising in a parovarian paramesonephric cyst.

BACKGROUND: Borderline parovarian tumors are found incidentally at surgery or autopsy. They are extremely rare. The majority have been reported in young women and rarely are they large enough to be clinically significant. CASE: A 53-year-old multiparous female with a symptomatic paraovarian serous borderline cystadenoma is presented. DISCUSSION: The clinical aspects and subsequent management of related cases are discussed.

Cystadenocarcinoma, Serous↗
PubMed1991

Detection of normotension, borderline and hypertension cutoffs in a population evaluated by non invasive blood pressure monitoring.

The 24-hour blood pressure (BP) average value in normotensive and hypertensive subjects is not defined. In 329 subjects three occasional blood pressure data were measured. The same day a non invasive 24-hour blood pressure monitoring was performed. The average of the occasional blood pressure and the average of the 24-hour blood pressure data were compared. In many cases the occasional blood pressure average was not strictly linked with the 24-hour blood pressure average. A statistical procedure (K-Means Cluster Analysis) was performed separately on occasional blood pressure values and on the hourly blood pressure average of the whole day. By this method three clusters of subjects were selected to evaluate the occasional and the 24-hour blood pressure cluster's cutoffs. The cluster's blood pressure cutoffs evaluated on occasional blood pressure values were not dissimilar from the blood pressure values suggested by literature for normotensive, borderline and hypertensive groups. The K-Means Clusters Analysis seems an interesting statistical method to research the subsets in a population evaluated by 24-hour blood pressure monitoring. We suggest that the 24-hour BP cutoffs evaluated in the three cluster groups may be considered as indicative for a clinical diagnosis of normotensive, borderline and hypertensive state.

Adult↗
PubMed1991

[Responses of the pressor and depressor regulatory systems to high sodium intake in borderline arterial hypertension].

A total of 25 healthy individuals and 48 borderline hypertensives aged 22-56 years were examined. The healthy subjects having a salt load showed elevated blood histamine concentrations and an unchanged vascular response to histamine, and reduced plasma renin activity. The patients having a salt load displayed high histamine levels, sharply decreased vascular response to histamine, and undepressed plasma renin activity. It is concluded that the pressor mechanisms responsible for controlling vascular tone are more active than the depressor ones during the salt load in patients with borderline hypertension. The humoral response of the patients to a salt load was impaired with elevated plasma cortisol concentrations, which was not followed by sodium retention in the body.

Adult↗
PubMed1991

[Fontan type procedure in patient with borderline hemodynamics: using a temporary R-L shunt in early postoperative period].

Fontan type procedure was successfully performed to a 14-year-old patient with borderline hemodynamics using a temporary R-L shunt in early post operative period. Preoperative diagnosis was DORV (ILD), small RV, PS, ASD, juxtaposition of atrial appendages and post bilateral B-T shunts. Preoperative catheterization studies showed low PARI but insufficient pulmonary arterial size (PA-index 220). In the Fontan procedure, RA was partitioned obliquely with a composite patch of xenograft and Dacron velour. A 5.5 mm hole was created only in xenograft to allow a temporary R-L shunt. During rewarming period, systemic pressure hovering around 60 mmHg with 10 micrograms/kg/min of dopamine and dobutamine. Then a R-L shunt was created by a side to side anastomosis between the appendages with the orifice diameter of 10 mm, followed by a rise in the systemic pressure up to about 80 mmHg. One post operative day, a readjustable occluder was applied at the site of appendage anastomosis to control R-L shunt flow. According as CVP decreased, the occluder was tightened up step by step. Finally, the occluder was fully tightened up in 10 post operative days. This experience suggests that a temporary R-L shunt in early post operative period may be applicable in patient with borderline hemodynamics for Fontan type procedure.

Adolescent↗
PubMedDate not supplied

[Child abuse: analysis of the problem and description of some "borderline" aspects].

In the present study, the A. put in evidence some "historical" aspects of the child abuse and neglect, and emphasize "borderline" cases of this problem. The importance of this analysis for the operators of the Public Health System is great. In effect, some "borderline" cases are results of ignorance of child psychology and lack of sanitary paediatric organization in the Paediatric Divisions.

Child↗
PubMed1991

Use of triphasic Tri-Regol tablet in women of borderline age.

Tri-Regol, a triphasic oral contraceptive tablet, has been used by 52 young and premenopausal fertile women during 189 cycles. Pregnancy was not observed, complication did not occur, none of the women discontinued the treatment because of health reasons. The women of both borderline age groups tolerated the tablet well which even exerted a therapeutic effect by controlling partly puberal cycle anomalies, partly premenopausal complaints. According to the author's opinion Tri-Regol is a valuable contraceptive for borderline age groups and may be useful as hormone therapy in certain cases.

Adolescent↗
PubMed1991

A critical interpretation of juvenile borderline hypertension.

The search for the genetic configuration of essential hypertension and the link with intermediate phenotypes ranks high on the current research agenda. Juvenile borderline hypertension is supposed to contain essential clues to the identification of these phenotypes. According to a large number of investigations, this condition is characterized by a labile type of hypertension and an elevation of the cardiac index, plasma catecholamines and/or renin activity. The 'prehypertensive' offspring from hypertensive parents may be included in these observations. The psychometric profile of the hypertensive patient also enters the equation. It seems likely that external conditions affect the manifestation of borderline hypertension. In particular, the stigma of the term hypertension appears to be carried over into the clinical findings, presenting as components of the pathophysiological and psychological profile. This calls for a reinterpretation of the patterns observed in early human hypertension.

Adolescent↗
PubMed1991

[Blood pressure with physical stress (ergometry) of 105 normotensive, borderline hypertensive and hypertensive children and adolescents].

Hypertension is one of the principal risk factors for cardiovascular diseases; its roots go back to childhood. A load study such as ergometry can help to recognise which persons are at risk. Ergometric measurements were performed by us on 105 children and adolescents, 72 of whom had borderline hypertensive or hypertensive blood pressure levels. Of these, the blood pressure rose during stress in 14%, the proportionate share being independent of the physical activity of the subjects. However, among those whose hypertension was on a borderline level, there was a disproportionately large percentage of obese subjects. These showed in addition an increase in blood pressure with increasing load and a reduced physical performance range. Obesity and lack of physical mobility had an unfavourable influence on blood pressure. Unfortunately there are no standardised rules for assessing the blood pressure during stress in children and adolescents. This would be all the more desirable since this easy examination is of prognostic value for an early discovery of manifest hypertension.

Adolescent↗

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