Periungual lesions in pyoderma gangrenosum.

Pyoderma gangrenosum (PG) is a progressive cutaneous necrosis of unknown origin. We report a case of PG presenting with periungual lesions. A 57-year-old woman was on treatment with ciclosporin A for PG. During tapering of the ciclosporin A dose, proliferating periungual lesions developed on the third and fourth finger of the left hand, the fourth finger of the right hand, and on the right great toe and the left fifth toe. All lesions appeared within a 4-week period. These abnormalities were ulcerated, involved about one-third of the distal part of the lateral nail folds including the part of nail fold bordering on the free edge of the nails, and were very painful. The skin biopsy was consistent with that seen in PG. Increasing the ciclosporin A dose led to significant improvement in the periungual lesions within the next few weeks and complete resolution within 6 months.

CTLA-4 gene polymorphisms and natural soluble CTLA-4 protein in psoriasis vulgaris.

CTLA-4 molecule is an important inhibitor of T-lymphocyte activation. Several single nucleotide polymorphisms (SNPs) in the CTLA-4 gene were found, and their associations with many human diseases were described. So far, however, such studies have not been performed in psoriasis vulgaris in Caucasoids. Therefore, we examined the distribution of three CTLA-4 SNPs: -1147C/T, -318C/T and +49 A/G in 116 patients with psoriasis vulgaris and 123 healthy blood donors using the polymerase chain reaction-restriction fragment length polymorphism method. For all three SNPs, the frequencies of alleles, genotypes and three-point haplotypes were very similar in patients and controls, suggesting no contribution of these genetic variants to psoriasis.

Cytomorphologic characterization of cell subsets isolated by density gradient centrifugation from tumor effusions of ovarian endometrioid carcinoma.

AIMS: Cytomorphologic characterization of tumor cell subsets, according to the stage of pathologic differentiation, and comparison of cellular composition in tumor cyst and ascitic fluids were carried out on individual patients with ovarian endometrioid carcinoma. METHODS: A density gradient centrifugation technique was applied to fractionate the cells from tumor effusions. RESULTS: The enrichment of cell forms representing individual stages of pathologic differentiation by gradient centrifugation facilitated their cytomorphologic characterization. According to cytomorphologic features, 5 discrete cell subpopulations were identified and catalogued. The cellular composition of tumor cyst and ascitic fluids in individual patients was similar, but the number of fractions and percentage of cell subsets differed. CONCLUSIONS: The estimation of precise cytomorphologic criteria for cell forms in tumor effusions facilitated the cytologic diagnosis of ovarian endometrioid carcinoma. The possibility to concentrate poorly differentiated, frankly malignant cell subsets in low densities could significantly improve the diagnosis of tumor effusions.

Relation between ovarian carcinoma-associated antigens in tumor tissue and detached cyst fluid cells of patients with ovarian neoplasms.

AIMS: The expression and potential diagnostic value of ovarian carcinoma-associated antigens were estimated in different types of epithelial ovarian neoplasms. The comparison of antigenic expression was performed on solid tumor tissues and loose cyst fluid cells in individual cases of malignant and benign ovarian neoplasms. METHODS: All studies were performed using monoclonal antibodies (mAbs) against ovarian carcinoma-associated antigens (OC125, OV-TL3, OV632, 10B, 8C) by 3-step peroxidase-antiperoxidase test. RESULTS: All ovarian carcinoma-associated antigens were detected in most serous and endometrioid carcinomas. In mucinous carcinomas as well as in benign ovarian neoplasms these antigens were present only in some cases. Significant inter- and intratumoral immunological heterogeneity was evident; however, the antigens detectable in tissue sections were also found in detached cyst fluid cells. CONCLUSIONS: Our results show that mAb show OV-TL3 is the best marker for endometrioid carcinomas and confirmed that mAbs OV632, OC125 and OV-TL3 could be good complementary markers for differentiating malignant and benign lesions in the ovary. The percentage content of all ovarian carcinoma-associated antigens in solid tumors and respective cyst fluid cells was comparable.

[Intraoperative verification of hysterosalpingographic and laparoscopic examination in cases of oviductal infertility]. / Sródoperacyjna weryfikacja badania histerosalpingograficznego i laparoskopowego w przypadkach nieplodnosci pochodzenia jajowodowego.

There has been made an analysis of 45 cases of women's oviductal infertility qualified to surgical treatment. In search of the reasons of infertility these patients underwent hysterosalpingographic examination and 24 of them additionally, diagnostic laparoscopy with chromotubation. Positive intraoperative verification of HSG and laparoscopy, as a confirmation of tubal obstruction, they obtained at 40 women (88.9%) that made possible to carry out microsurgical operations in them. Such a big percentage of correct diagnoses makes sure, that both hysterosalpingography and laparoscopy are indispensable for proper qualification of a patient to microsurgical treatment of oviductal infertility.

[Treatment outcome of surgery for oviductal infertility using microsurgery techniques on material of the I department and clinic of the Gynecology Academy of Medicine in Wroclaw]. / Wyniki leczenia operacyjnego nieplodnosci pochodzenia jajowodowego przy zastosowaniu techniki mikrochirurgicznej na materiale I Katedry i Kliniki Ginekologii Akademii Medycznej we Wroclawiu.

Since September 1988 to October 1992 in the I Department and Clinic of Gynaecology Medical Academy of Wroclaw 40 women were operated on infertility due to oviductal factor. This kind of infertility has been previously diagnosed by hysterosalpingography examination and then verified in 22 cases (55%) by laparoscopy combined with chromotubation. The operations were carried out with use of microsurgical technique and instruments. At the same time the prophylaxis of postoperative intraperitoneal adhesions was applied. Seven pregnancies were obtained, that makes 17.5% of success. It is an outcome comparable with results presented by many other world centres of gynaecological microsurgery.

[Laparoscopic verification of hysterosalpingographic image]. / Laparoskopowa weryfikacja obrazów histerosalpingograficznych.

The authors discuss 47 cases in which the HSG examination showed secondary tubular unpatency, then verified by laparoscopy. The patients were divided in three groups. The patients who belonged to the first group had two-sides tubular unpatency recognized by HSG. In 26 of these patients the HSG result was confirmed by laparoscopy, in 3 cases--it was not. The second group were 14 patients with partial tubular unpatency showed by HSG. In 10 of these cases the laparoscopic examination gave results consistent with HSG, in 4 cases--contradictory. The last group was formed by 6 patients with no tubular unpatency recognized through HSG. 4 of these recognitions were confirmed by laparoscopy, while 2 were not. In the opinion of the authors supported by the results the HSG examination may be considered only as a preliminary element of tubular patency examination. In case of planned microsurgery the only qualifying or disqualifying examination is the laparoscopy with introduction of colour contrast.

[Laparoscopic evaluation of reproductive organs in women treated for infertility]. / Laparoskopowa ocena narzadów plciowych u kobiet leczonych z powodu nieplodnosci.

The authors discuss 84 cases of laparoscopic examination of women with primary or secondary infertility. The patients qualified for this examination had undergone at least 26 weeks of conventional treatment with no effect. In 7 cases the reproductive organ was found to be in order, with fallopian tubes fully patent. In 43 cases tubular inpatency was found. The remaining patients suffered from other reproductive organ disorders. Therefore, the laparoscopic examination made detailed recognition of the causes of infertility possible and thus helped to establish the proper treatment. Additionally, in some cases it enabled the immediate removal of the source of infertility.

Comparison of cellular phenotypes in tumor cyst and ascitic fluid from ovarian serous carcinoma.

Density gradient centrifugation was applied to isolate cell subsets from tumor cyst and ascitic fluid in eight patients with ovarian serous carcinoma. A comparison of cellular composition and immunologic reactivity of cells from the cysts and from ascitic fluid in each patient was performed. Some differences in density profiles were found, but in each case the consistency of morphologic cell forms in the primary tumor and ascites was documented. Immunophenotypic analyses of isolated cellular fractions using polyclonal and monoclonal antibodies against ovarian carcinoma-associated antigens showed significant immunologic intratumoral heterogeneity. However, there was a similarity of antigen expression in cells from the primary tumors and ascitic fluids. Our study indicated that morphologic and antigenic characterization of a given tumor could be determined in a single representative sample of ascitic fluid.

[Clinical study on the contraceptive effectiveness of trisiston from the Jenapharm firm]. / Kliniczna ocena skutecznosci antykoncepcyjnej preparatu trisiston firmy Jenapharm.

Now triphasic contraceptive preparations are used widely. Some news low dose formulations are available on the market, among them Trisiston. The study was conducted to confirm clinically acceptance and effectiveness of Trisiston. There were 437 volunteers mostly multiparous, with a mean age of +/- 25 years who participated in a multi center study. They were taking pills for a 3 to 12 cycles. Cumulatively 4026 cycles were observed. The investigation was conducted according special protocol. At the admission a complete medical history was obtained and a general physical and gynecological examination was performed. All subject were controlled every 3rd month included laboratory tests (blood levels of Hb, WBC, RBC, ESR, carbohydrate metabolism, clotting factors, bilirubin, creatinine, protein, glucose, albumin, LDL, HDL). There was no case of pregnancy. Pearl index = 0. The Trisiston was well tolerated by most of women (80%). Some effects like headache, vertigo, mastalgia, spotting and breakthrough bleeding, loss of libido, premenstrual syndrome were observed in 20% patients, soma of our patients (20%) discontinued contraceptive.

Density distribution and immunological reactivity of tumor cells from peritoneal effusions of patients with ovarian neoplasms.

Ascitic samples from 19 patients with primary ovarian non-mucinous carcinomas, three with Krukenberg tumors and eight with noncancerous peritoneal effusions were studied by conventional cytology and immunocytochemical staining. Density gradient centrifugation was applied to fractionate ascitic fluid cells. The enrichment of cell types by this method facilitated their cytomorphological characterization and identification of neoplastic cell subpopulations existing in peritoneal effusions. Immunophenotypic studies of cells were made using monoclonal antibodies (mAbs) against ovarian carcinoma-associated antigens (OC 125, 10B, 8C) and carcino-embryonic antigen (CEA). Non-specific cross-reacting antigen (NCA) was applied as a marker for granulocytes which often accompany peritoneal effusions. Our results indicated that immunofluorescence (IF) staining contributed to the distinction between the primary and secondary ovarian carcinomas. Density gradient centrifugation appeared to be a useful method for separation of mesothelial cells.

Group-specific component (GC) and transferrin (TF) subtypes in psoriatic patients.

Frequency of occurrence of TFC and GC subtypes and determining genes was evaluated in 90 and 68 nonrelated psoriatic patients, respectively. The obtained distributions of frequencies were compared with those recorded in healthy population. No statistically significant differences were observed.

CA 125 and carcinoembryonic antigen levels in cyst fluid, ascites and serum of patients with ovarian neoplasms.

The levels of CA 125 and carcinoembryonic antigen (CEA) in tumour cyst fluid, ascites and serum of patients with epithelial ovarian neoplasms were estimated. In addition, the serum concentration of both antigens was evaluated 10 days after operation. Independently of histological type of ovarian tumour, CA 125 and CEA values were significantly higher in cyst and ascitic fluid than in corresponding patients' serum. The higher values of both markers were also found in malignant than benign ovarian cysts. CEA occurred at higher concentrations in mucinous carcinomas whereas CA 125 values were comparable both in mucinous and serous cyst fluid. The levels of these markers in cyst fluid did not correlate with the serum concentrations. The significant individual differences existed in the ability of tumour cells to produce and release both studied antigens. Post-operative CEA levels returned to normal more slow than CA 125 values.

Reactivity of polyclonal and two monoclonal antibodies with cell subsets isolated from cystic fluids of ovarian serous neoplasms.

The distribution of antigenic determinants on a cellular level in serous ovarian neoplasms was evaluated using polyclonal and two monoclonal antibodies (OC 125 and 10B). The expression of antigens was estimated by an immunofluorescence test on each cell fraction isolated by density centrifugation from cystic fluids of individual malignant and benign ovarian tumors, taking into account the density and cytomorphologic features of cell subpopulations. It was found that the studied antibodies recognized different antigenic determinants. Significant immunologic heterogeneity of cells among and within individual tumors was shown. Our studies show the value of isolated cell subpopulations for comparing the reactivity of different antibodies and estimating their immunodiagnostic potency.

[Examination of the correlation between transferrin C and atopic dermatitis]. / Badanie korelacji pomiedzy podtypami transferyny C a atopowym zapaleniem skóry.

Transferrin subtypes are considered to be some of genetic markers which can correlate with the incidence of certain diseases. The present study was designed to find out whether such a correlation is true for atopic dermatitis. Transferrin C subtypes (Tf CI, Tf C2, Tf C3) in blood serum were determined by the method of isoelectric focussing in polyacrylamide gel. Examinations were made in 30 atopic dermatitis patients. The control group was made up by a Polish population sample of 728 normal persons of both sexes. The results obtained were analysed statistically by means of test chi 2. There was no correlation between Tf C and atopic dermatitis (chi 2 = 0,638, d.f. = 2, 0,750 greater than p greater than 0,500).

[Usefulness of photochemotherapy in allergic diseases of the skin]. / Przydatnosc fotochemoterapii w chorobach alergicznych skórky.

PUVA treatment was applied in 16 patients with chronic urticaria (7 with solar urticaria, 2 with cold urticaria and 7 with urticaria of unknown etiology), 26 with chronic disseminated eczema and 41 with atopic dermatitis. In all 9 patients with physical urticaria, a clear-cut improvement was observed. The results from the treatment of chronic urticaria of unknown etiology were considerably poorer (improvement in 2 out of 7 cases). In patients with chronic disseminated eczema, a full remission was present in 5 and considerable improvement in 20 cases. In group of 41 patients with atopic dermatitis, 52 cures were carried out; in 8 patients the cure was repeated 2-3 times at 1,0-0,5-year intervals. Complete recovery was achieved in 34 and significant improvement in 16 out of them. The results presented seem to indicate the effectiveness of PUVA treatment to some allergic skin diseases, the more so that the number of exposures required to obtain a considerable improvement, or even full remission, is comparatively low (3-21 occasions), which reduces the risk of complications.

[A case of coexistence of Bowen's disease of the vulva with pre-invasive cancer of the cervix uteri]. / Przypadek wspólistnienia choroby Bowena sromu z rakiem przedinwazyjnym szyjki macicy.

The Bowen disease is rare, especially when the focus is located on the vulva. In each case of diagnosis of+ the disease, one should also examine the patient with respect of the coexistence of an additional neoplastic focus in the skin or other internal organs. In their teaching hospital the authors observed a patient in whom the Bowen disease coexisted with preinvasive cervical carcinoma.

[Further studies of diabetic microangiopathy in children with insulin-dependent diabetes mellitus. Electron microscopy studies]. / Weitere Forschungen zur diabetischen Mikroangiopathie bei Kindern mit insulinabhängigem Diabetes mellitus. Elektronenmikroskopische Untersuchungen.

Electronmicroscopy examinations of the skin vessels were performed in 20 well compensated children with insulin-dependent diabetes mellitus (14 girls and 6 boys ages from 4 to 18 years). The results were compared with 10 healthy ones. In 17 patients the electron-microscopic picture was pathologic, with varying of intensity. Structurally, the most relevant changes were represented by thickening of the basal membrane (in some cases with its multiplication), swelling of endothelial cells, decrease in number of pinocytic vesicules and presence of deposits with increased electron density in the pericarion and the perivascular space. Vascular disturbances may develop very early, sometimes in the first month after manifestation of the disease. The authors suggest, that further investigations are necessary to elucidate the nature of the observed changes. An intensification of insulin therapy would be also considered.

Density distribution and antigenic characterization of cell subpopulations isolated from cystic fluids of ovarian serous neoplasms.

The immunological reactivity of serous ovarian tumor cells was evaluated, taking into account their density and morphological features. Discontinuous density gradient centrifugation was applied to fractionate cell subpopulations from cystic fluids of patients with ovarian serous carcinomas, cystadenomas and benign serous cysts. For phenotypic characterization of tumor cell subpopulations the immune sera against perchloric acid extracts of ovarian serous (anti-PCA-CaOs) and mucinous (anti-PCA-CaOm) carcinomas were used. The expression of carcinoembryonic antigen (CEA) and nonspecific cross-reacting antigen (NCA) on tumor cell fractions was also checked. Some relationship between immunological reactivity, cell morphology and cell density was found; however, individual patient-to-patient variations in cellular composition and antigenic expression were also observed. The presence of ovarian serous carcinoma-associated antigen (CaOs-Ag) was related mainly to frankly malignant cells. Neither CEA nor NCA were constant and characteristic markers for serous ovarian neoplasms. These neoplasms were unreactive with anti-PCA-CaOm serum. Our results indicate the possibility of correlation between morphological features, density distribution and immunological phenotypes of ovarian tumor cell populations.