Borderline ovarian tumor frozen section diagnoses with features suspicious of invasive cancer: a retrospective study

Background A frozen section diagnosis of a borderline ovarian tumor with suspicious features of invasive carcinoma (“at least borderline” or synonymous descriptions) presents us with the dilemma of whether or not to perform a full ovarian cancer staging procedure. Quantification of this dilemma may help us with the issue of this clinical decision. The present study assessed and compared both the prevalence of straightforward borderline and “at least borderline” frozen section diagnoses and the proportion of these women with a final histopathological diagnosis of invasive carcinoma, with a special interest in histologic subtypes. Methods A retrospective cohort study was performed in three hospitals in The Netherlands. All women that underwent ovarian surgery with perioperative frozen section evaluation in one of these hospitals between January 2007 and July 2018 were identified and included in case of a borderline or “at least borderline” frozen section diagnosis and a borderline ovarian tumor or invasive carcinoma as a final diagnosis. Results A total of 223 women were included, of which 41 women (18.4%) were diagnosed with “at least borderline” at frozen section. Thirteen of forty-one women (31.7%) following “at least borderline” frozen section diagnosis and 14 of 182 women (7.7%) following a straightforward borderline frozen section diagnosis were diagnosed with invasive carcinoma at paraffin section evaluation (p < 0.001). When compared to straightforward borderline frozen section diagnoses, the proportion of women diagnosed with invasive carcinoma increased from 3.1 to 35.7% for serous tumors (p = 0.001), 10.0 to 21.7% for mucinous tumors (p = 0.129) and 50.0 to 75.0% (p = 0.452) in case of other histologic subtypes following an “at least borderline” frozen section diagnosis. Conclusions Overall, when compared to women with a decisive borderline frozen section diagnosis, women diagnosed with “at least borderline” frozen section diagnoses were found to have a higher chance of carcinoma upon final diagnosis (7.7% vs 31.7%). Especially in the serous subtype, full staging during initial surgery might be considered after preoperative consent to prevent a second surgical procedure or chemotherapy in unstaged women. Further studies are needed to evaluate whether additional sampling in case of an “at least borderline” diagnosis may decrease the risk of surgical over-treatment.

Splenogonadal fusion: aiding detection and avoiding radical orchidectomy

Splenogonadal fusion is a rare benign congenital anomaly in which there is an abnormal connection between the gonad and the spleen. It was first described over 100 years ago with limited reports in the literature since then. Its similarity in presentation to testicular neoplasia poses a significant challenge in diagnosis and management, often resulting in radical orchidectomy. We present the case of a 31-year-old man who presented with a rapidly growing left-sided testicular mass and suspicious ultrasound findings; histology from the subsequent radical inguinal orchidectomy showed findings consistent with splenogonadal fusion. We describe points for consideration in the clinical history, examination and imaging that could suggest splenogonadal fusion, including preoperative technetium-99m-sulfur colloid imaging and intraoperative frozen section evaluation, which may confirm the diagnosis and prevent unnecessary orchidectomy.

Role of Information Professional for the Growth of Altmetrics in the Digital Era

Any librarian in this field will need to continue not only filling these roles, but also ensuring that they themselves are part of the conversation as it moves forward and staying up-to-date with developments within this area. The concept of library involvement pertaining to metrics did not originate with altmetrics. Impact Factor was originally created primarily for use by librarians in making collection development and retention decisions. Libraries continue to bear primary responsibility for the acquisition of bibliometrics tools, most notably Web of Science, Journal Citation Reports, and Scopus, as well as the training of people in their use. As a result, librarians are already familiar with providing support for these tools, so it makes sense that librarians have expanded to support the variety of altmetrics sources and tools. Additionally, librarians serve as natural leaders when it comes to altmetrics, not only due to familiarity with resources, but also because of the relationships they maintain with several disparate groups. The article detailed about the various tools, section, evaluation methods in which libraries and librarians are supporting and interacting with altmetrics.

The study results of the filtration process in the ground dams body and its chemical effect on piezometers

The article describes the definition of filtration flow gradients in the dam's body on the example of the Kattakurgan reservoir, the analysis of the reasons for their change in cross-section. Evaluation of the aggressiveness of the filtration flow in the dam's body plays an important role in ensuring the stability of the reservoir dam and its parts. To assess the aggressiveness of the filtration flow in the dam's body, it is necessary to know the action pattern of the filtration water in the reservoir dam and its effect on the elements of the dam. In addition, the chemical composition of the water in the piezometers was analyzed in the laboratory to determine the aggressive effect of sulfate elements on the piezometers and their corrosion. Measures on the observations of systemic piezometers were also mentioned.