New onset diabetes with ketoacidosis following nivolumab immunotherapy: A case report and review of literature.

INTRODUCTION: Immune-checkpoint inhibitors have become an increasingly popular form of systemic therapy for cancer treatment. Their use has proven to be so effective that certain regimens have gained approval as first-line therapy for various solid tumor types. The most common and well-studied forms of immunotherapy include agents that target cytotoxic T-lymphocyte antigen-4, programmed death-1, and programmed death ligand-1. These therapies act by blocking signaling between immune cells and cancer cells which subsequently augment T cell-mediated destruction of tumor cells. CASE REPORT: Here, we report a case of a 77-year-old black male with no history of or risk factors for diabetes mellitus who presented with acute onset of diabetic ketoacidosis after beginning immunotherapy with nivolumab for metastatic high-grade neuroendocrine tumor of the lung. He was admitted and treated for diabetic ketoacidosis but required prolonged use of an insulin infusion with frequent need of intravenous dextrose due to labile blood sugars. The patient was eventually discharged and discontinued further immunotherapy with nivolumab. DISCUSSION: Due to the unique mechanisms by which immune-checkpoint inhibitors cause immune-mediated destruction of tumor cells, clinicians may be challenged with their associated autoimmune complications referred to as immune-related adverse events. In particular, the incidence of endocrine dysfunction following immune-checkpoint inhibitor therapy is approximately 12%, with the development of insulin-dependent diabetes mellitus being a rare complication. Increasing awareness of immune-related adverse events is essential for the early recognition and effective management of patients who present with life-threatening complications related to immune-checkpoint inhibitor therapy.

Obesity and diet awareness among Polish children and adolescents in small towns and villages.

BACKGROUND: In addition to genetic predispositions and environmental factors, healthy lifestyle education is very important for children and adolescents. The purpose of this research was to estimate the number of overweight and obese children and adolescents from small towns and villages and to find out an association between health awareness in children and the risk of becoming overweight or obese. METHODS: The research was conducted in 1,515 healthy children aged 6-18 years from small towns and villages in Poland. Overweight was diagnosed when BMI for age and sex was over the 90th percentile; obesity--when it was over the 95th percentile. The study consisted of a lifestyle interview and anthropometrical measurements. The lifestyle interview was conducted with the use of an anonymous questionnaire form and included questions about food frequency, diet habits and physical activity. The research was analysed using the SAS System for Windows, release 8.02. RESULTS: Overweight status was diagnosed in 9.0% and obesity in 5.1% of respondents. Excess body mass was statistically more frequently diagnosed in girls than in boys aged 14-18 years. Girls of this age group significantly more frequently chose wholemeal bread, smoked sausages, meat and poultry as products that are believed to keep them fit. Older children substantially more often indicated that stress, smoking cigarettes, consuming fatty meat, sweets, being obese, and a lack of physical activity are factors that damage health. Boys spent more time in front of a computer or TV than girls; in the older group of children, the phenomenon even intensified. CONCLUSION: Awareness of healthy lifestyle behaviour is not sufficient to maintain optimal body mass. Knowledge about proper eating habits is better among girls than among boys, especially in the older age groups. However, in older groups, there was less physical activity due to spending more time in front of TV or the computer. High percentage of obese/overweight children and insufficient knowledge of nutrition may consequently result in increased risk of cardio-vascular diseases in adult population.

Adherence to the 2021 dietary guidelines of the European Society of Cardiology on cardiovascular disease prevention in residents of the Pomeranian Voivodeship with increased cardiovascular risk.

INTRODUCTION: Good eating habits can reduce cardiovascular risk. OBJECTIVES: The aim of this work was to verify the compliance with the new European Society of Cardiology (ESC) dietary guidelines in people with increased risk of cardiovascular disease. PATIENTS AND METHODS: The study included 1244 current or former smokers (636 men and 608 women) at a mean (SD) age of 61.6 (6.4) years who volunteered for the MOLTEST BIS lung cancer prevention program. During the program, 49% of the patients were diagnosed with one of the following: arterial hypertension (AH), diabetes mellitus (DM), or coronary artery disease (CAD). The patients with lung cancer were excluded from the study. The participants completed a Food Frequency Questionnaire (FFQ­6) and their food intake was assessed with a 24­hour dietary recall method. RESULTS: Only 2% of the studied individuals declared consuming more than 2 servings of both fruits and vegetables every day, and only 3% of the respondents confirmed daily nut consumption. Most of them weighed too much, consumed too little fiber, and derived too much energy from total and saturated fats. The mean animal to plant protein ratio was higher than recommended, as was the omega­6 to omega­3 fatty acid ratio. Only 40% of the participants with AH, DM, or CAD had a daily cholesterol intake below 200 mg, and in only 12% of them less than 7% of total energy came from saturated fats. CONCLUSIONS: The smokers with increased cardiovascular risk did not comply with the 2021 ESC dietary recommendations. The most common error was inadequate consumption of vegetables, fruits, and nuts.

Inappropriate dietary habits in tobacco smokers as a potential risk factor for lung cancer: Pomeranian cohort study.

OBJECTIVE: Little is known whether diet quality modulates lung cancer risk in smokers. The aim of the study was to assess the dietary habits of a large group of volunteers participating in the lung cancer screening program. METHODS: The 62-item food frequency questionaire was completed by 5997 participants, 127 of whom (2.1%) were later diagnosed with lung cancer. Two approaches were applied to identify dietary habits. The non-healthy diet index was calculated, and a direct analysis of the frequency of consumption was used. A logistic regression analysis was performed to estimate the association between food product intake and the risk of lung cancer. RESULTS: The study population did not follow the Polish nutritional recommendations. They consumed fruits and vegetables too rarely and far too often ate non-recommended foods, such as processed meat, refined products, sugar, sweets, and salty snacks. Participants diagnosed with lung cancer more often consumed low-quality processed meat, red meat, fats, and refined bread and less often whole-grain products, tropical fruits, milk, fermented unsweetened milk drinks, nuts, honey, and wine. The non-healthy diet index score was significantly higher in those with cancer diagnosis compared with those without lung cancer (11.9 ± 5.2 versus 10.9 ± 5.3; P < 0.001). CONCLUSIONS: The surveyed population of smokers did not follow dietary recommendations; there was a particularly high index of an unhealthy diet in by people diagnosed with lung cancer. Prevention programs should be based on encouraging smoking cessation, lifestyle modification, and methods of early detection of lung cancer. Lifestyle modification should include changing eating habits based on a healthy diet, which may be an additional factor in reducing the risk of developing cancer.

Parameters of antioxidant barrier in different histopathologic types of pediatric cancers.

AIM OF THE STUDY: The goal of this study was to evaluate the activities of erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and the levels of glutathione (GSH) and ischemia-modified albumin (IMA), as potential markers in different histopathologic types of pediatric neoplasms. No studies on this subject have been reported to date. MATERIAL AND METHODS: SOD, GSH-Px, GSH, and IMA were measured before oncologic treatment in 129 children with neuroblastoma (NB), soft tissue sarcomas (STS), brain tumors, Hodgkin's disease (HD), and acute leukemias, and in 30 healthy controls. RESULTS: The statistical significance of SOD was observed in patients with brain tumors (median 1840.2 U/g Hb, p = 0.0500). The level of GSH was significantly higher in patients with NB (median 6.38 U/g Hb, p = 0.0031) and leukemias (5.16 U/g Hb, p = 0.0200). IMA was statistically significant in cases of STS, NB, and leukemias compared to healthy children (p = 0.0244, p = 0.0069, and p = 0.0000, respectively). The activity of GSH-Px was not statistically significant. CONCLUSIONS: The antioxidant barrier in all types of pediatric cancers is disturbed. None of the measured parameters was specific enough to represent a reliable marker for any particular histopathologic type of children's neoplasm.

Plant-based diets contribute to lower circulating leptin in healthy subjects independently of BMI.

Much research has shown how important role leptin - a hormone secreted by adipose tissue - plays in the regulation of human body weight, mainly due to its appetite-decreasing effects. Under the conditions of energy balance, leptin is an indicator of the amount of triglycerides stored in adipose tissue. In contrast, in a state of hunger or overeating, it acts as an energy balance sensor, and when its level is too high, it fails to reduce food intake, disturbing maintenance of the proper body mass. Recent studies indicate that there is a relationship between a vegetarian diet and the decreased incidence of cardiovascular diseases, certain types of cancer and obesity. It has been noted that people on plant-based diets have lower body weight and percentage of body fat than omnivores. The aim of the study was to analyze the relationship between serum leptin concentrations and the type of diet. The 143 female volunteers on a vegetarian, vegan or omnivore diet were enrolled in the study. All participants had normal body weight (BMI≥18.5<24.9kg/m2). There were statistically significant differences in the serum leptin concentrations of the studied women. Both in the group of vegetarians and vegans circulating leptin was significantly lower (p<0.001) than in the group of omnivores, with the lack of differences in neither BMI nor in body fat content. This suggests that leptin levels are affected not only by the amount of stored fat, but also by the consumed food. This observation indicates the health-promoting properties of plant diets, by influencing circulating leptin.

The antioxidant status and response to therapy in children with soft tissue sarcomas and neuroblastoma.

BACKGROUND: Antioxidant systems in cells maintain the proper homeostasis of reactive oxygen species, which at high concentrations can induce carcinogenesis. The aim of this study was to evaluate the serum levels of ischemia-modified albumin (IMA), erythrocyte superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) as markers for prognosis in children with neuroblastoma (NB) and soft tissue sarcomas (STS), two cancer types for which reliable prognostic factors are needed. PROCEDURE: SOD, GSH-Px, and IMA were measured before and during responses to therapy assessment in 99 children with NB and STS and in 30 healthy controls. RESULTS: There were no statistically significant differences in the erythrocyte SOD and GSH-Px activities between the patients with cancer and healthy controls. The levels of IMA in patients with STS and NB were found to be significantly higher than in the controls (P = 0.0013; P = 0.0066, and 0.0164, respectively). Decreased activities of SOD and GSH-Px were found in all patients with poor-responding (PRS) cancers and decreased SOD activity was found in patients with PRS NB. An increase in GSH-Px was observed in patients with good-responding (GR) NB. All patients with GR cancers demonstrated higher SOD and GSH-Px activities than patients with PRS cancers. CONCLUSIONS: While determining the levels of specific antioxidants as antioxidant-barrier parameters in children with cancer may be valuable in predicting therapeutic responses as well as outcomes, additional studies are required.

Ischemia-modified albumin as a biochemical marker in children with neuroblastoma and soft tissue sarcomas.

In this study, the levels of ischemia-modified albumin (IMA) in pediatric oncology patients with soft tissue sarcomas (STSs) and neuroblastoma (NB) were analyzed. To date, there have been no studies concerning IMA in these groups of patients. Ninety-nine children with STSs and NB were analyzed from 2006 to 2009, and 30 healthy children were also enrolled in the study. IMA levels were measured throughout treatment in all patients. The levels of IMA in all cancer patients (mean 116.8±39.3 U/ml), in patients with STSs (mean 119.8±27.5 U/ml), and in patients with NB (mean 114.6±36.6 U/ml) were significantly higher than in the control patients (mean 87.3±38.3 U/ml; P=0.0013, 0.0066, and 0.0164, respectively). IMA levels increased before and during the treatment compared with levels in the controls. The determination of IMA levels in pediatric oncology patients with poor prognoses from STSs and NB may play an important role in predicting response to therapy and overall outcome.

Lipid profile in Polish women following lacto-ovo-vegetarian and vegan diets - preliminary study.

The European Atherosclerosis Society and American College of Cardiology and American Heart Association guidelines have introduced several new recommendations, according to which vegetarian diets are concerned as beneficial for the cardiovascular system. This study was aimed to investigate the lipid profile in 56 healthy Polish young women - 13 vegans, 18 lacto-ovo-vegetarians and 25 omnivores. HDL cholesterol concentrations were higher in the vegans and vegetarians than in the omnivores. LDL cholesterol levels were lower in the vegans than in both other diet groups. The use of a vegetarian - especially vegan - diet in Polish conditions is associated with a favorable lipid profile and may have cardioprotective effects.

Giant Prolactinoma Presenting With Facial Nerve Palsy and Hemiparesis.

BACKGROUND: Giant prolactinomas are an exceedingly uncommon type of pituitary adenomas that usually occur in men, and cause extremely high prolactin levels and mass-related symptoms. Rarely, patients may experience neurological deficits resembling ischemic events. METHODS: We describe an unusual case of a young man who presented with stroke-like symptoms and was found to have a giant prolactinoma. CLINICAL CASE: A 25-year-old man presented with left facial droop and gradually progressing upper and lower extremity weakness for evaluation of stroke. He reported recent weight gain and erectile dysfunction. Physical examination revealed left homonymous hemianopsia, left VII nerve palsy, and left hemiparesis. Magnetic resonance imaging of the brain showed an enormous mass in the sella turcica, which invaded the sphenoid sinus and right side of the skull base. Prolactin level was elevated at 13 580 ng/mL, and the testosterone level was low. The patient was started on cabergoline and had marked improvement in his symptoms in a few months. Fifteen months after starting treatment, he has had more than 90% reduction in tumor volume and a 93% reduction in prolactin level. CONCLUSION: Giant prolactinomas are uncommon and present with compressive symptoms that can be mistaken for a stroke. Our case is a unique report of a facial nerve palsy and hemiparesis secondary to giant prolactinoma in the absence of stroke or pituitary apoplexy.

Hashimoto Encephalopathy With Status Epilepticus.

Hashimoto encephalopathy (HE) is a heterogenous neurological syndrome that can manifest with encephalopathy, seizures, headaches, and variable neuropsychiatric disturbances. The underlying mechanism remains unclear; however, autoimmune pathogenesis is suspected due to its association with autoimmune thyroid disease, high titers of anti-thyroid antibodies, and quick response to steroid therapy. We report a 59-year-old female patient with a remote history of hypothyroidism who presented with status epilepticus and complaints of chronic headaches and cognitive impairment. The presence of sharp frontal waves was identified on her EEG. The patient was initially started on anti-epileptics only; however, her headaches and memory loss escalated, further diagnostic workup was pursued, which revealed high anti-thyroid peroxidase antibodies with normal thyroid function tests. The only cerebrospinal fluid (CSF) abnormality noticed was an elevated protein concentration. MRI showed non-specific right frontal lobe pial enhancement. Remaining infectious, rheumatologic, and neurologic testing was unremarkable. The patient was started on a steroid regimen with successful resolution of symptoms and return of cognitive baseline. Hashimoto's encephalopathy is a diagnosis of exclusion; however, it should be considered in patients with high titers of anti-thyroid antibodies and neurological symptoms that cannot be explained by thorough infectious, metabolic, and autoimmune testing. It is essential to recognize this neurological entity as fast clinical improvement may be achieved with steroids and other immunotherapies.

Empiric Determination of the Daily Glucocorticoid Replacement Dose in Adrenal Insufficiency.

BACKGROUND: For the treatment of adrenal insufficiency (AI) in adults, the Endocrine Society's recommended daily glucocorticoid replacement dose (DGRD) is 15 to 25 mg hydrocortisone (HC), which is approximately 1.7 times the reported mean daily cortisol production rate. Prolonged glucocorticoid overtreatment causes multiple morbidities. HYPOTHESIS: We tested the hypotheses that the DGRD, empirically determined by individual patient titration, is lower than that of the Endocrine Society guidelines and tolerated without evidence of glucocorticoid under-replacement. METHODS: We empirically determined the DGRD in 25 otherwise healthy adults with AI by titrating the DGRD to the lowest dose tolerated as judged by body mass index, blood pressure, serum sodium concentration and AI symptoms. Patients received either HC or prednisone (PRED). The HC equivalent of PRED was assumed to be 4:1. RESULTS: The mean empirically determined DGRD, expressed as HC equivalent, was significantly less than the midpoint of the Endocrine Society's recommended DGRD (7.6 ± 3.5 mg/m2 vs 11.8 mg/m2; P < 0.001). The DGRD in the adrenalectomy group was not significantly different than the DGRD of those with other AI causes (7.9 ± 4.0 mg/m2 vs 7.3 ± 3.1 mg/m2; P = ns), demonstrating that the empirically determined DGRD was not biased by residual cortisol secretion. There was no evidence of glucocorticoid under-replacement as determined by measured biometrics and AI symptoms. CONCLUSIONS: We conclude that an empirically determined DGRD is significantly lower than that of the Endocrine Society guidelines and tolerated without evidence of glucocorticoid under-replacement.

Association between different types of plant-based diets and leptin levels in healthy volunteers.

Leptin is an important factor regulating appetite and energety metabolism; disturbances in its signaling are related to adiposity and contribute to the excessive body fat. About a third of the human population is overweight or suffers from obesity, as well as from associated medical conditions. It is well established that vegetarian, especially vegan, diet is very effective in lowering BMI and body fat, thus, plant-based diets are associated with a lower risk of obesity. The aim of this study was to evaluate the plasma levels of leptin in lacto-ovo-vegetarian and vegan volunteers with normal BMI. The intake of energy and selected diet components such as polyunsaturated fatty acids (PUFA) and carbohydrates was also investigated. The study involved healthy women - 14 omnivores, 17 lacto-ovo-vegetarians, and 11 vegans. All women had a normal BMI (18.5-24.99). The plasma leptin levels were examined with immunoenzymatic test (ELISA). All participants were interviewed to estimate their nutrient intake by performing a 24-hour dietary recall. Both lacto-ovo-vegetarians and vegans had lower plasma leptin concentrations than their meat-consuming counterparts. Every analyzed diet group had a different body fat content, with the highest level in omnivores and the lowest in vegans. All participants had similar calorie, total fat, and total carbohydrates intake. Total PUFA and specifically omega-3 fatty acids consumption was lower in omnivores when compared to both types of plant diet; the same was found for fiber intake. Our results suggest that adopting a plant-based diet may be beneficial for energetic metabolism, as it significantly lowers the body fat storage and circulating leptin levels.

Cardiopulmonary exercise test and bioimpedance as prediction tools to predict the outcomes of obesity treatment.

INTRODUCTION Obesity impacts the global population. Bioelectrical impedance analysis (BIA) and cardiopulmonary exercise test [CPET]) may help modify the treatment. OBJECTIVES We aimed to compare BIA and CPET results in obese and lean indivisuals, assess changes in BIA and CPET during obesity treatment, and indentify parameters predicting treatment outcome. PATIENTS AND METHODS We enrolled 200 obese patients, of whom 45 underwent a lifestyle modification treatment, and 32 lean individuals (controls). Lifestyle modifications included diet, rehabilitation, education, and behavioral therapy. The diet was based on body composition assessed by BIA and fat metabolism assessed by CPET. The intensity of exercise in the rehabilitation program was based on CPET, mainly peak oxygen uptake (VO2peak), fat metabolism (FAT), and fat heart rate (FAT HR). The protocol duration was 12 weeks. RESULTS Obese patients differed from lean controls with regard to VO2peak (P <0.0001), oxygen uptake at anaerobic threshold (P <0.0002), respiratory exchange ratio (P <0.014), oxygen uptake to work rate slope (P <0.0004), FAT (P <0.001), FAT HR (P <0.0008), anaerobic threshold heart rate (P <0.0003), as well as fat mass (P = 0.01), fat­free mass (P = 0.007), resting metabolic rate (RMR) (P = 0.007), total body water (P = 0.01), and extracellular water (P = 0.004). The treatment resulted in increased RMR (P <0.02) and VO2peak (P <0.002), as well as reduced fat tissue (P <0.006) and resting heart rate (P <0.017). The prediction model based on FAT HR, resting heart rate, and FAT enabled the prediction of treatment outcomes in 92% of patients. CONCLUSIONS Obese patients had pathological FAT and impaired exercise tolerance. Changes in BIA and CPET prove the metabolic impact of lifestyle modification treatment.

Iron status and dietary iron intake in vegetarians.

BACKGROUND: Iron is one of the nutrients that require special consideration in a plant-based diet. The widespread belief is that meat is the best source of iron and a vegetarian diet increases the risk of its deficiency. This conviction has been the subject of analysis in a growing number of scientific reports. OBJECTIVES: The aim of this study was to assess the iron intake and iron metabolism in vegetarians and vegans compared to a control group. MATERIAL AND METHODS: A total of 55 vegetarians and 36 healthy volunteers were studied. The following parameters were measured in serum: iron, ferritin, transferrin, transferrin receptor, and hepcidin-25, using the enzyme-linked immunosorbent assay (ELISA) method. The dietary iron intake was assessed by a 24-h dietary recall. RESULTS: The mean daily intake (DI) of iron was significantly higher in the female vegan group compared to the control group. Iron, hepcidin-25, ferritin and transferrin receptor in serum remained within their normal ranges. The ferritin concentration was significantly decreased and that of transferrin significantly higher in both female groups and in the male vegan group. CONCLUSIONS: The obtained results show that the studied parameters, excluding transferrin, remained within normal ranges. However, the ferritin concentration was significantly decreased in the female vegetarian group and also in both vegan groups. This may indicate low iron storage.

Differences in gene expression related to the outcomes of obesity treatment, peak oxygen uptake, and fatty acid metabolism measured in a cardiopulmonary exercise test.

INTRODUCTION The obesity pandemic requires development of methods that could be used on a large scale, such as the cardiopulmonary exercise test (CPET). Gene expression may explain CPET results on the molecular level. OBJECTIVES The aim of this study was to compare gene expression in obesity, depending on CPET results. PATIENTS AND METHODS The study group consisted of 9 obese patients and 7 controls. The treatment encompassed diet, rehabilitation, and behavioral therapy. Diet was based on the body composition analyzed by bioelectrical impedance, resting metabolic rate, and subjective patient preferences. The rehabilitation depended on the CPET results: maximal oxygen uptake and fatty acid metabolism. Behavioral intervention focused on the diagnosis of health problems leading to obesity, lifestyle modification, training in self­assessment, and development of healthy habits. The intensive treatment lasted for 12 weeks and consisted of consultations with a physician, dietitian, and medical rehabilitation specialist. RNA was isolated from the whole blood. A total of 47 323 transcripts were analyzed, of which 32 379 entities were confirmed to have high quality of RNA. RESULTS We observed differences in gene expression related to the CPET results indicating abnormalities in fat oxidation and maximal oxygen uptake. The genes with major differences in expression were: CLEC12A, HLA­DRB1, HLA­DRB4, HLA­A29.1, IFIT1, and LOC100133662. CONCLUSIONS The differences in gene expression may account for the outcomes of treatment related to inflammation caused by obesity, which affects the muscles, fat tissue, and fatty acid metabolism.

Anthropometry and body composition of adolescents in cracow, poland.

BACKGROUND AND OBJECTIVE: The aim of the present study was to determine the level of adiposity and obesity in Polish adolescents and compare the results with earlier studies conducted in this population as well as those carried out in other populations. METHODS: The study group consisted of 456 boys and 514 girls aged 14-18 years living in Cracow chosen from randomly selected secondary schools. Weight, height, waist, and hip circumference (WC, HC) as well as triceps, biceps, subscapular, and suprailiac skinfold thickness (SFT) were measured. Body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), subscapular/triceps skinfold ratio (STR), and percentage body fat were computed. The prevalence of overweight and obesity based on Polish children growth reference were calculated and age-dependent and gender-specific smoothed percentile curves for BMI and ROC curves were generated. RESULTS: Weight, height, WC, HC (up 16yr), WHtR (up 15yr), and WHR were considerably higher in males than females. Weight, height, and HC increased with age; WHtR remained the same. The prevalence of overweight and obesity were 10.2% (boys 10.3%; girls 10.1%) and 4.2% (boys 5.3%; girls 3.3%). ROC analysis revealed that WHtR was the best tool for detection of obesity (AUC of 0.982±0.007) in males, whereas the sum of four SFTs (AUC: 0.968±0.011) and WHtR (AUC: 0.963±0.012) were the best predictors of obesity in females. CONCLUSIONS: The level of adiposity in Cracow adolescents increased during the last decade. However, it is still lower than in other well-developed societies struggling with obesity epidemics.

[Diagnostic value of the morphological ultrasound score system and the serum concentration of CA 125 in the diagnosis of malignant ovarian cancer]. / Wartosc diagnostyczna morfologicznych indeksów ultrasonograficznych oraz oznaczen stezenia CA 125 w rozpoznawaniu nowotworów jajnika.

OBJECTIVES: The aim of this study was to estimate the diagnostic value of the morphological ultrasound score system and the serum concentration of CA 125 in the diagnosis of malignant ovarian masses. The aim was realized by the evaluation of the statistical coefficients like sensitivity, specificity, positive predictive value and negative predictive value in three groups tested by different methods (A--ultrasonography, B--serum concentration of CA 125, C--both methods). MATERIALS AND METHODS: We have analyzed 59 patients (17-77 years old)--mean 46.5 +/- 14.8 with ovarian malignant masses diagnosed in years 1999-2001. RESULTS: Merz morphological ultrasound score system revealed its sensitivity of 92.3%, specificity--87.9%, positive predictive value--85.7% and negative predictive value--93.7%. Statistical coefficients for serum Ca 125 marker concentration was not so attractive: sensitivity--57.7%, specificity--90.9%, positive predictive value--83.4% and negative predictive value--73.2%. Using both methods at the same time we obtained significantly different coefficients: sensitivity--96.2%, specificity--80.0%, positive predictive value--78.1% and negative predictive value--96.6%. CONCLUSIONS: Ultrasound assessment of ovarian morphology is very useful element in early detection of ovarian neoplasm. Serum CA 125 concentration assay is not a test verifying malignancy. Using both methods at the same time we increase its sensitivity and negative predictive value.

[Lymphangioma--prenatal and perinatal aspects--Part one]. / Naczyniak limfatyczny--aspekty prenatalne i perinatalne--czesc pierwsza.

Lymphangioma or cystic hygroma is a congenital malformation of the lymphatic system which has been commonly associated with fetal aneuploidy, hydrops, structural malformations and intrauterine death. In this paper we would like to report two cases of lymphangioma diagnosed prenatally in the third trimester in the fetuses with normal karyotype, normal NT in the first trimester and without other structural anomalies and with good perinatal outcome.