Characterization of histologic pattern provides valuable information in the management of uterine carcinosarcoma.

Uterine fundal pressure maneuver during the second stage of labor increased the risk of severe perineal laceration. The use of the maneuver must be cautioned and careful attention must be paid to its application.

Oncostatin M (OSM) is a member of the interleukin-6 superfamily and a multifunctional cytokine that effects the growth and differentiation of many different cell types. OSM concentrations in the sera of pregnant women were found to be significantly higher than those of non-pregnant women. Western blot analysis revealed that the OSM protein was present in the decidua and chorionic tissue in each trimester. Throughout pregnancy, the amount of the OSM protein in the decidua was larger than that in the chorionic tissue. Immunohistochemistry using an anti-OSM monoclonal antibody demonstrated that OSM was mainly localized in the decidual glands and stroma. OSM transcripts in the decidua and the chorionic tissue were detected during each trimester by reverse transcription-polymerase chain reaction (RT-PCR). The regulation of human chorionic gonadotrophin (HCG) release by the placenta in first trimester stimulated with recombinant OSM was also investigated. Stimulation of the placenta by OSM augmented HCG release in a time- and dose-dependent manner. HCG release induced by recombinant human OSM was completely blocked by antibodies against OSM and the signal transducer, gp130, but only partially inhibited by antibodies against the leukaemia inhibiting factor (LIF) receptor. These results suggest that OSM molecules produced by decidual glands and stromal cells during pregnancy have an important role in placental endocrine function.

Objective To evaluate the effect of lymphovascular space invasion on survival of early-stage epithelial ovarian cancer patients. Methods A multicenter retrospective study was conducted for patients with stage IA-C epithelial ovarian cancer who underwent primary comprehensive surgery including lymphadenectomy. Histopathology slides for ovarian tumors were examined by gynecologic pathologists for presence or absence of lymphovascular space invasion. Survival analysis was performed examining tumoral factors. Results A total of 434 cases were included in the analysis. Lymphovascular space invasion was detected in 76 (17.5%) cases, associated with histology (p=0.042) and stage (p=0.044). Lymphovascular space invasion was significantly associated with decreased survival outcomes (disease-free survival [DFS], 5-year rate 78.4% versus 90.7%, p=0.024, and overall survival [OS], 84.9% versus 93.2%, p=0.031) in univariate analysis. In multivariate analysis, lymphovascular space invasion did not remain a significant variable for DFS (hazard ratio [HR] 1.98, 95%CI 0.97-3.97, p=0.059) or OS (HR 2.41, 95%CI 0.99-5.85, p=0.052). Lymphovascular space invasion was associated with increased risk of hematogenous and lymphatic metastasis (HR 4.79, 95%CI 1.75-13.2, p=0.002) but not peritoneal metastasis (p=0.33) in multivariate analysis. Among lymphovascular space invasion-expressing tumors, patients who received fewer than 6 cycles of postoperative chemotherapy had significantly poorer DFS than those who received six or more cycles (HR 4.59, 95%CI 1.20-17.5, p=0.015). Conclusion Lymphovascular space invasion is an important histological feature to identify a subgroup of patients with increased risk of recurrence in stage I epithelial ovarian cancer.