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Skinner SM, Lee VH, Kieback DG, Jones LA, Kaplan AL, Dunbar BS. Identification of a meiotically expressed carbohydrate antigen in ovarian carcinoma: I. Immunohistochemical localization. Anticancer Res 1997; 17:901-6. [PMID: 9137425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A monoclonal antibody developed against a meiotically expressed porcine oocyte carbohydrate antigen has been shown to recognize an antigen in ovarian surface epithelial cells. Immunohistochemical studies of ovaries demonstrated that this antigen is present in the ovarian surface epithelia (OSE) of numerous mammalian species, including the non-human primate and the human (1). Although most of the ovarian surface epithelial cells are lost during aging in the human, a few cells may remain in ovarian crypts. In view of theories that most ovarian carcinomas are derived from the OSE cells in aging women, the PS1 antibody has been used to evaluate ovarian tumors using immunocytochemistry to detect the PS1 antigen in paraffin embedded pathology tissues. The present study found that the PS1 antigen is abundant in a number of malignant ovarian tumors, but is not expressed in a non-malignant Brenner's (ovarian) tumor or granulosa cell tumors. This antibody therefore appears to have great potential for the histopathological and immunochemical analysis of ovarian tumors.
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Verschraegen CF, Levy T, Kudelka AP, Llerena E, Ende K, Freedman RS, Edwards CL, Hord M, Steger M, Kaplan AL, Kieback D, Fishman A, Kavanagh JJ. Phase II study of irinotecan in prior chemotherapy-treated squamous cell carcinoma of the cervix. J Clin Oncol 1997; 15:625-31. [PMID: 9053486 DOI: 10.1200/jco.1997.15.2.625] [Citation(s) in RCA: 93] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE A phase II study was performed to evaluate the antitumor activity and toxicity of irinotecan (CPT-11), a water-soluble derivative of camptothecin, in patients with prior chemotherapy-treated squamous cell cancer of the cervix. PATIENTS AND METHODS Forty-two patients were included in the study. The median age was 44 years (range, 24 to 59 years). The median Zubrod performance status was 1. All patients were refractory to first-line chemotherapy and 88% had received prior radiotherapy. The initial dose of CPT-11 was 125 mg/m2 given as a weekly 90-minute intravenous infusion for 4 weeks, every 6 weeks. Subsequent doses were unchanged, reduced, or omitted according to toxicity grade. RESULTS Forty-two patients were assessable for response. The overall response rate was 21%. The median time to response was 6 weeks and the median duration of response was 12 weeks. The overall median duration of survival was 6.4 months. A statistically significant survival advantage (median of 12.6 v 5.1 months) was found in patients whose disease responded to the treatment (P < .015). The major dose-limiting toxic effects (grade > or = 3) were nausea and vomiting (45%), diarrhea (24%), and granulocytopenia (36%). Grade > or = 3 anemia was encountered in 62% of patients and the incidence of thrombocytopenia was negligible. Less severe side effects were alopecia (48%), drug fever (43%), anorexia (33%), fatigue (33%), skin rash (21%), stomatitis (14%), and allergic reaction (9%). The gastrointestinal intolerance was dose-related. The incidence of bone marrow depression did not decrease with dose reduction, possibly because of a cumulative effect or hematologic intolerance by a subset of patients. CONCLUSIONS CPT-11 has significant activity in refractory cervical carcinoma. Gastrointestinal intolerance and hematologic toxicity must be monitored carefully. Further studies of alternative schedules may improve the tolerance and response rate.
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Fishman A, Demirel D, Laucirica R, Ramzy I, Klima T, Lyzak J, Kaplan AL. Malignant tumors arising in endometriosis: clinical-pathological study and flow cytometry analysis. Eur J Obstet Gynecol Reprod Biol 1996; 70:69-74. [PMID: 9031923 DOI: 10.1016/s0301-2115(96)02563-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Malignant transformation to endometriosis is a well documented phenomenon that occurs most commonly in the ovaries with cancer arising in extra-ovarian endometriosis being a rare event. METHODS A retrospective clinical-pathological evaluation of eleven cases with malignant tumors arising in endometriosis was performed to evaluate the prognostic impact of various factors. Nuclear DNA content (ploidy) was assessed through flow cytometric study. RESULTS Ovarian origin was identified in eight cases and three were associated with extra-ovarian endometriosis. Histologic type was endometrioid carcinoma in ten patients. The eleventh case had high grade endometrial stromal sarcoma. All tumors were diploid with no relation to stage, grade, or clinical outcome. The S-phase fraction (SPF) was analyzed in nine patients and no correlation could be demonstrated with any histologic parameters or clinical outcome. CONCLUSIONS The DNA content seems to have no association with the classical prognostic parameters in these cases.
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Fishman A, Kudelka AP, Tresukosol D, Edwards CL, Freedman RS, Kaplan AL, Girtanner RE, Kavanagh JJ. Leuprolide acetate for treating refractory or persistent ovarian granulosa cell tumor. THE JOURNAL OF REPRODUCTIVE MEDICINE 1996; 41:393-6. [PMID: 8799913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate leuprolide acetate for treating refractory or persistent ovarian granulosa cell tumor (GCT). STUDY DESIGN We treated six patients who had recurrent or persistent ovarian GCT with monthly intramuscular injections of a depot formulation of leuprolide acetate, 7.5 mg. Four patients had received prior cisplatin-based chemotherapy. Initially these patients' tumors had responded to the cisplatin, but then the disease had progressed in all cases. One of these four patients also had received prior therapy with tamoxifen that had resulted in three months of stable disease. Two patients had received no prior chemotherapy. RESULTS Responses could be evaluated in five of the six patients; in the sixth patient, only survival was evaluable. Among the five evaluable patients, two achieved partial responses lasting 3 and 11 months, with disease progression-free intervals of 4 and 12 months. The other three patients (60%; 95% confidence interval [CI], 20-95%), including two whose disease had progressed on chemotherapy, had stable disease with disease progression-free intervals of 3+, 3+ and 13+ months. The objective response rate was 40% (two of five patients; 95% CI, 10-90%). Cessation of disease progression was noted in all five of the evaluable patients (100%; 95% CI, 40-100%). The sixth patient, whose disease could not be evaluated, was treated with leuprolide acetate for 24 months and at this writing had no clinical evidence of disease. The therapy was convenient to administer, and no major side effects were noted. Leuprolide acetate thus appears to have activity in patients with refractory GCT, and it may prolong the disease progression-free interval. Further trials of this relatively nontoxic and convenient therapy are warranted.
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Tauchi PS, Caraway N, Truong LD, Kaplan AL, Ramzy I. Serous surface carcinoma of the peritoneum: useful role of cytology in differential diagnosis and follow-up. Acta Cytol 1996; 40:429-36. [PMID: 8669174 DOI: 10.1159/000333894] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To determine the role of cytology in differentiating serous surface carcinoma of the peritoneum (SSCP) from other morphologically similar tumors, including ovarian carcinoma and other peritoneal lesions, and to define the value of cytology in the follow-up of patients with SSCP. STUDY DESIGN Twenty-one ascitic fluids and seven peritoneal washings obtained from 19 patients with histologically confirmed SSCP were reviewed and their cytologic features tabulated and analyzed. RESULTS Eighteen of the specimens were from initial diagnostic paracenteses or exploratory laparotomies. These showed mostly three-dimensional tumor cell clusters, as well as single malignant cells, with occasional papillae. The cytoplasm was abundant and often vacuolated. The cytomorphologic features of SSCP enabled differentiation from other conditions involving the peritoneal surface, including mesothelial hyperplasia, malignant mesothelioma, endometriosis and endosalpingiosis. However, there were no characteristic features that differentiated SSCP from metastatic serous carcinoma of the ovary. Four of the peritoneal washings were from second-look operations; in each of these cases the presence of tumor cells in the cytologic preparations correlated with positive biopsy results. Furthermore, six of the paracenteses were performed for recurrent ascites and enabled detection of recurrent disease, obviating the need for invasive procedures. CONCLUSION Cytomorphologic examination of ascitic fluids and peritoneal washings serves a valuable role in the initial diagnosis of SSCP, in the detection of recurrent disease and as a useful adjunct to multiple biopsies in the second-look operation. It can differentiate SSCP from several other lesions but not from serous carcinoma of the ovary.
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Demirel D, Laucirica R, Fishman A, Owens RG, Grey MM, Kaplan AL, Ramzy I. Ovarian tumors of low malignant potential. Correlation of DNA index and S-phase fraction with histopathologic grade and clinical outcome. Cancer 1996; 77:1494-500. [PMID: 8608534 DOI: 10.1002/(sici)1097-0142(19960415)77:8<1494::aid-cncr11>3.0.co;2-v] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND DNA ploidy and/or S-phase fraction have been used as biologic predictors of aggressive behavior in a variety of solid tumors, including ovarian carcinomas. Recently, attention has focused on borderline lesions to determine if flow cytometry plays a role in separating potentially aggressive tumors from those which will pursue a more innocuous course. METHODS Paraffin-embedded tissue from 42 tumors with low malignant potential (LMP) were analyzed by flow cytometry (FC) to determine the DNA index (DI) and S-phase fraction (SPF). These result were then correlated with conventional pathologic parameters (size, nuclear grade, architecture, and mitotic index) and with clinical parameters (stage and age). Statistical analysis was carried out using the Fisher's Exact and Kruskal-Wallis tests. RESULTS Thirty-five cases (83.3%) were diploid, while 7 cases (16.7%) showed aneuploid stemlines, with a mean DI of 1.2 (range: 1.1-1.4). The mean SPF was 3.5% for the diploid tumors and 4.5% for the aneuploid tumors. Serous tumors comprised 74% of our cases; the remainder were either mucinous or endometrioid tumors. Complex solid architectural patterns were found in 29 tumors whereas high nuclear grade was seen in 24. A mitotic rate (MR) of 0-3/10 high power fields was seen in 29 tumors (69%), with only 5 having 10 or more mitotic figures. Aneuploidy statistically correlated with higher stage (P < 0.009). Marginal correlation was seen with a larger tumor size (P = 0.06). SPF showed a direct linear correlation with MR (P < 0.001). Also, smaller SPF's were seen in the serous tumors versus the mucinous and endometroid group (P < 0.05). Two patients with diploid and one patient with aneuploid stemlines had recurrent disease during the follow-up period. CONCLUSIONS DI and SPF correlated with some of the histologic parameters we evaluated. DI and SPF, however, could not predict which tumor(s) would behave in a more aggressive fashion.
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Fishman A, Otey LP, Poindexter AN, Shannon RL, Girtanner RE, Kaplan AL. Aggressive angiomyxoma of the pelvis and perineum. A case report. THE JOURNAL OF REPRODUCTIVE MEDICINE 1995; 40:665-9. [PMID: 8576887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Aggressive angiomyxoma of the female perineum and pelvis is a slowly growing neoplasm occurring almost exclusively in women of reproductive age. The tumor is characterized by its locally infiltrative behavior. The high recurrence rate has been attributed to incomplete surgical excision. CASE A case of a huge, recurrent, aggressive angiomyxoma of the perineum and pelvis was treated. CONCLUSION Correct preoperative diagnosis and assessment of simultaneous perineal and pelvic involvement indicate a combined abdominoperineal surgical approach to achieve wide, tumor-free margins.
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Miller CS, Dembo JB, Falace DA, Kaplan AL. Salivary cortisol response to dental treatment of varying stress. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1995; 79:436-41. [PMID: 7614201 DOI: 10.1016/s1079-2104(05)80123-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The physiologic stress of various dental procedures (dental examination, dental prophylaxis, restoration, root canal therapy, and tooth extraction) was measured in 50 nonsmoking healthy men between the ages of 18 and 55 years (mean 34.6 years, range 21 to 53 years) with a salivary cortisol assay. Expectorated saliva was collected at four time points: 10 minutes before the start of the procedure, 15 minutes after the patient was seated, at the end of the procedure, and 1 hour after the completion of the procedure. Of the 196 samples included for analysis, mean cortisol values ranged from 0.1 to 3.8 micrograms/dl with a recovery of 100% +/- 8.4%. The mean cortisol value for the extraction group (1.09 +/- 0.42 microgram/dl) was significantly different (p < 0.05) from the mean values of the examination (0.46 +/- 0.10 microgram/dl), prophylaxis (0.64 +/- 0.64 microgram/dl), root canal (0.49 +/- 0.07 microgram/dl), and restorative (0.60 +/- 0.04 microgram/dl) groups as determined by the Duncan's multiple range test. Cortisol levels decreased from the initial reading to the end of the procedure by about 15% for patients undergoing an examination, root canal, and restorative procedure. Cortisol levels at the end of the procedure were elevated in the prophylaxis (55%) and extraction (148%) groups compared with the baseline cortisol recording. A minority of patients in the prophylaxis group had elevated cortisol levels throughout dental treatment, whereas cortisol levels were elevated during treatment in 80% of patients undergoing extraction. These data suggest that the adrenal stress response associated with tooth extraction(s) is greater than that associated with other routine dental procedures.
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Henry RG, Johnson HA, Holley MM, Kaplan AL. Response to patients' death and bereavement in dental practice. SPECIAL CARE IN DENTISTRY 1995; 15:20-5. [PMID: 7676362 DOI: 10.1111/j.1754-4505.1995.tb00467.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Coping with patient deaths and family bereavement has received minimal attention in dental education and literature. This study was conducted to determine how frequently dentists experience patient deaths, how they cope with the knowledge of a patient's death, and if they demonstrate need for emphasis in the dental curricula in the areas of death and bereavement. A survey adapted from Chiodo and Tolle (1988) was sent to all 2091 dentists in the State of Kentucky. The response rate was 47.68% (997 returned surveys). Findings include: (1) General dentists (GDs) have a significantly higher number of patients who die each year than do specialists (S) (GD = 7, S = 1.5); (2) coping behaviors range from sending sympathy cards (63%) to attending the funeral (23%); (3) patient deaths cause stress, most stress occurring when patients die unexpectedly; (4) the greatest stress was encountered when talking with the patient's family; and (5) most dentists (58%) believed that bereavement education should occur in dental school. In conclusion, this research adds to the limited literature on appropriate coping behaviors by dentists when patients die and suggests that death and bereavement education should occur in the dental school setting to prepare practicing dentists for coping with patient loss due to death, and to provide family bereavement support mechanisms.
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Fishman A, Kim HS, Girtanner RE, Kaplan AL. Solitary breast metastasis as first manifestation of ovarian carcinoid tumor. Gynecol Oncol 1994; 54:222-6. [PMID: 8063251 DOI: 10.1006/gyno.1994.1198] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Carcinoid tumor metastatic to the breast is very uncommon. The rarity of this finding may be the reason for its common misinterpretation as primary breast carcinoma. A patient with primary ovarian carcinoid that presented initially with a solitary breast mass is reported. A review of the literature discloses only 12 reported cases of carcinoid tumor metastatic to the breast, with none of the primaries found to be the ovary.
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Fishman A, Girtanner RE, Adam E, Kaufman RH, Kaplan AL. Second primary cancer arising from the neovulva following reconstruction with myocutaneous flaps. Gynecol Oncol 1994; 53:128-30. [PMID: 8175013 DOI: 10.1006/gyno.1994.1101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Myocutaneous flaps have been used for vulvar reconstruction following radical vulvectomy. For over 15 years the most common complications related to these flaps are sloughing of the skin and donor site wound infection. A new malignancy arising from the skin of the neovulva is an unusual occurrence. Two cases are presented. The skin of the neovulva may be exposed to the same neoplastic carcinogens that caused the initial lesion. In both patients, the polymerase chain reaction method failed to detect the presence of human papillomavirus DNA in either the initial lesion or the recurrent cancer.
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Fishman A, Ortega E, Girtanner RE, Kaplan AL. Malacoplakia of the vagina presenting as a pelvic mass. Gynecol Oncol 1993; 49:380-2. [PMID: 8314542 DOI: 10.1006/gyno.1993.1144] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Malacoplakia is an unusual type of chronic inflammation that rarely involves the female genital tract. A case of malacoplakia involving the vaginal cuff of a patient previously treated by radical hysterectomy for cervical carcinoma is presented.
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Miller CS, Kaplan AL, Guest GF, Cottone JA. Documenting medication use in adult dental patients: 1987-1991. J Am Dent Assoc 1992; 123:40-8. [PMID: 1469204 DOI: 10.14219/jada.archive.1992.0293] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The authors surveyed 5,002 dental outpatients to determine the prevalence and patterns of drug use. They found that drug use increased significantly with age and that a significant number of patients took medications that had potential for adverse dental effects. Thus, dentists should be aware of patient medications and the effects those drugs have on dental treatment.
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Levitan Z, Kaplan AL, Kaufman RH. Advanced squamous cell carcinoma of the vulva after treatment for verrucous carcinoma. A case report. THE JOURNAL OF REPRODUCTIVE MEDICINE 1992; 37:889-92. [PMID: 1479576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Verrucous carcinoma of the vulva, a rare variant of squamous cell carcinoma, is a locally destructive, nonmetastasizing tumor. While controversy surrounds the choice of treatment for this lesion, which frequently recurs, it is generally accepted that a recurrence is almost always local, with histologic characteristics and biologic behavior the same as those of the primary tumor. A case of squamous cell carcinoma of the vulva with involvement of the regional lymph nodes after treatment of verrucous carcinoma is reported to increase awareness of the potential biologic behavior of this uncommon tumor.
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Kopczyk RA, Abrams H, Brown AT, Matheny JL, Kaplan AL. Clinical and microbiological effects of a sanguinaria-containing mouthrinse and dentifrice with and without fluoride during 6 months of use. J Periodontol 1991; 62:617-22. [PMID: 1770421 DOI: 10.1902/jop.1991.62.10.617] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The purpose of this study was to test the efficacy and safety of sanguinaria-containing regimens with and without fluoride using the American Dental Association guidelines for evaluating chemotherapeutic agents. The study was a 6-month, double-blind, 4-cell, placebo-controlled, parallel investigation involving 120 subjects. Following screening procedures, subjects were randomly assigned to 4 groups. Group 1 received a dentifrice containing 0.075% sanguinaria extract (SaE) and 2.0% zinc chloride (ZnCl2) in a dicalcium phosphate base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2. Group 2 received identical products without SaE or ZnCl2. Group 3 received a dentifrice containing 0.8% sodium monofluorophosphate, 0.075% SaE, and 0.05% ZnCl2 in a silica base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2. Group 4 products were identical to those of Group 3 but without SaE and ZnCl2. Supragingival plaque and gingival inflammation were scored at 0, 1, 2, 1.5, 3, 4.5, and 6 months; bleeding upon probing was measured at 1, 1.5, 3, and 6 months. Microbiological samples were taken from plaque, tongue, and cheek areas. The active products produced statistically significantly lower scores than the placebo agents for all indices (P less than .0001). Six-month plaque scores were 13.1% lower for Group 1 and 17.4% lower for Group 3 compared to placebo products. When the Plaque Severity Index was applied, the percentage reductions were 33% for Group 1 and 41% for Group 3 compared to placebos. Gingival inflammation scores were 16.7% lower for Group 1 and 18.1% lower for Group 3 at 6 months compared to placebo scores.(ABSTRACT TRUNCATED AT 250 WORDS)
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Kaplan AL, Lillich TT. Assessing information resource needs in a college of dentistry. J Dent Educ 1991; 55:154-60. [PMID: 1990028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Levitan Z, Kaplan AL, Gordon AN. Survival after malignant pericardial effusion and cardiac tamponade in advanced ovarian cancer. South Med J 1990; 83:241-2. [PMID: 2305307 DOI: 10.1097/00007611-199002000-00028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Malignant pericardial effusion and tamponade are rarely seen complications of epithelial ovarian cancer. With the use of multiagent chemotherapy these complications may be seen more frequently in the future. Therapy should be individualized, as long-term survival may be possible if the systemic manifestations of the cancer can be controlled.
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Truong LD, Maccato ML, Awalt H, Cagle PT, Schwartz MR, Kaplan AL. Serous surface carcinoma of the peritoneum: a clinicopathologic study of 22 cases. Hum Pathol 1990; 21:99-110. [PMID: 1688545 DOI: 10.1016/0046-8177(90)90081-f] [Citation(s) in RCA: 94] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Serous surface carcinoma (SSC) of the peritoneum is defined as a primary tumor histologically indistinguishable from serous carcinoma of the ovary, diffusely involving the peritoneal surface but sparing or only superficially invading the ovaries. In this study of 22 cases of SSC, it was found that the main clinical manifestations of SSC were abdominal pain and enlargement. In most cases, SSC evenly involved the entire mesothelial surface but rarely was predominant in or even limited to the pelvis. It frequently invaded the submesothelium, but deep invasion into abdominal and pelvic organs or local metastasis was rare, and distant metastasis was not seen at presentation. Microscopically, SSC was a high-grade tumor frequently showing high mitotic rate, psammomas bodies, and necrosis. The tumor was usually contiguous with hyperplastic mesothelium on either ovarian surface or other locations. Tumor cells in all cases except one showed cytoplasmic or surface neutral or acidic mucin or both. Tumor cells stained positive for keratin (100% of cases), epithelial membrane antigen (100%), Leu-M1 (45%), B72.3 (85%), vimentin (35%), and carcinoembryonic antigen (25%). Electron microscopic studies of six cases showed epithelial differentiation in each. Seven patients (32%) were alive with no clinical disease at 3 to 31 months, one patient (4%) was alive with extensive local disease at 24 months, 11 patients (50%) died almost exclusively of local recurrence at 1 to 70 months, and three patients (14%) died of operative complications. It is concluded that SSC arises from peritoneal mesothelium but has epithelial phenotype. It can be morphologically differentiated from other conditions with similar laparotomy findings, such as malignant mesothelioma, benign papillary mesothelioma, cystic mesothelioma, and benign or borderline peritoneal serous tumors. The prognosis of SSC is poor, and most patients die of uncontrollable local disease.
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Levitan Z, Gordon AN, Kaplan AL, Kaufman RH. Primary malignant melanoma of the vagina: report of four cases and review of the literature. Gynecol Oncol 1989; 33:85-90. [PMID: 2649421 DOI: 10.1016/0090-8258(89)90609-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Four cases of malignant melanoma arising in the vagina are described, and the literature related to this unusual tumor is reviewed. The 2-year survival rate is better following radical surgery than after other treatment modalities; however, the 5-year survival rate is unrelated to type of therapy. Radical surgery appears to control local disease, but fails to address systemic spread of the tumor. Therefore, improvement in survival will require effective systemic therapy.
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Kaplan AL. [Acute abdomen in obstetrics and gynecology]. FEL'DSHER I AKUSHERKA 1989; 54:29-34. [PMID: 2703073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Kaplan AL. [Procedure of the nurse midwife in placenta praevia]. FEL'DSHER I AKUSHERKA 1988; 53:21-6. [PMID: 3181467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Kaufman RH, Bornstein J, Gordon AN, Adam E, Kaplan AL, Adler-Storthz K. Detection of human papillomavirus DNA in advanced epithelial ovarian carcinoma. Gynecol Oncol 1987; 27:340-9. [PMID: 3040545 DOI: 10.1016/0090-8258(87)90256-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Tissue specimens from 10 out of 12 patients with advanced epithelial ovarian adenocarcinoma contained DNA of human papillomavirus type 6 (HPV-6). HPV DNA was identified by in situ hybridization at high stringency using biotin-labeled DNA probes. Nonneoplastic tissue specimens from other pelvic sites of the same patients were also examined. None showed evidence of HPV DNA. The meaning of these findings in relation to epithelial ovarian carcinoma is discussed.
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Kaplan AL. [Tasks of the midwife in preventing injuries during labor]. FEL'DSHER I AKUSHERKA 1987; 52:8-14. [PMID: 3647889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Kaplan AL. [The biological mechanism of labor]. FEL'DSHER I AKUSHERKA 1987; 52:16-20. [PMID: 3646962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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