Incidental tubal endometrioid adenocarcinoma - case report.

The fallopian tubes represent a highly important structure for ovarian carcinogenesis. They provide the passage of eutopic endometrium from the uterus, as well as metastatic cells from the ovaries. A direct source of tumor cells for ovarian cancer was also recently confirmed in the fallopian tubes. The authors present a case report of an incidental tubal endometrioid carcinoma with the coexistence of adenomyosis.

Changes in urine autofluorescence in ovarian cancer patients.

Ovarian cancer is the type of cancer with the highest mortality rate among gynaecologic malignancies. Due to lack of screening tools, this disease is mainly diagnosed at a progressed stage, when it is too late to adequate therapy. Despite many attempts, enough sensitive and specific biomarker was not still uncovered. Fluorescence spectroscopy has proven to be a useful diagnostic tool with high efficiency. Fluorescence detection has three major advantages over other light-based investigation methods: high sensitivity, high speed, and reliability. Biological materials consist of a number of intrinsic fluorescent compounds -autofluorophores, which are associated with cardinal metabolic pathways. It is well known, that cancerous tissue metabolism is altered compared to healthy one, what influence also intrinsic fluorophores composition of bodily fluids. Urine is one of the biological fluids that could be obtained most easily and displays a blue - green fluorescence that can change in case of pathological process. Analysis of urine autofluorescence is non invasive and simple technique. Using fluorescent spectroscopy, ovarian cancer patients and healthy control group were discerned with high significance, so we predict that fluorescence analysis of urine could be a potential means of ovarian cancer screening.

Borderline ovarian tumor - a case report with genetic testing.

Despite an accurate classification, the borderline category of ovarian tumors is one of the most controversial topics in gynecologic oncology and is confusing to both clinicians and patients. The treatment is often confronted with the necessity of a fertility-sparing approach, although under-treatment increases the risk of disease recurrence. The clear definition of a group of patients with low or high risk of relapse requiring more or less extensive treatment is lacking. Currently, the main criteria affecting the treatment extent include histopathological features, particularly the presence of microinvasion, and invasive implants. Expansion of knowledge about genetic nature of the tumor characteristics may more closely specify the scope of therapeutic approach for individual patients. The authors report a case report of serous borderline ovarian tumor patient with tumor cell dispersion into the gastrointestinal tract. The genes of tumor vascular markers GPM6B and DR6 were also studied and compared to a group of healthy patients.

Histopathological alterations in the antral ovarian follicles in dairy cows with a tendency to emaciation.

The aim of the study was to define interrelationships between histopathological alterations in ovarian antral follicles and body condition in dairy cows with a tendency to emaciation (BCS 1 and 2) compared with dairy cows with normal body condition (BCS 3). The ovaries were recovered from slaughtered cyclic dairy cows (at the luteal phase of the cycle) of Czech Fleckvieh and Holstein breeds at different times of the post-partum period. The animals were estimated as belonging to certain grade of body condition score (BCS) according to a 5-point scale. Only dairy cows with BCS1 (emaciation; n=6), BCS2 (tendency to emaciation; n=5) and BCS3 (optimal body condition status; n=6) were available for the experiment. The ovarian samples were embedded into Technovit 7100 resin; the tissue sections were stained with buffered basic fuchsine with toluidine blue. For acidic mucopolysaccharides (aMPS) a combination of PAS-technique with Alcian blue was used. Histological analysis showed that emaciation was associated with an increased occurrence of late (cystic) and luteinization-related atresia in granulosa and theca cells and increased levels of aMPS in small atretic follicles. Our observations indicate that dairy cows with a tendency to emaciation (BCS 2) or emaciated (BCS 1) have elevated occurrence of late atresia and atresia with luteinization, while initial atresia is less. This expands our basic knowledge of ovarian histopathology providing new insight into the association of antral follicle atresia and body condition status in dairy cows.

[New and clinically used oncomarkers of bladder cancer]. / Nové a klinicky vyuzívané onkomarkery karcinómu mocového mechúra.

Bladder cancer is the fourth most common cancer in men and the eighth most common cancer in women. Oncomarkers play a crucial role in early detection of bladder cancer, as well as in treatment response monitoring and prognosis. Search for a new marker by molecular analysis is in progress because any diagnostic sensitivity and specificity enhancement is a great benefit for clinical practice.

[The impact of exogenous luteinizing hormone on IVF/ICSI cycles parameters]. / Vplyv exogénneho luteinizacného hormónu na parametre IVF/ICSI cyklov.

OBJECTIVE: To evaluate the effect of exogenous luteinizing hormone on IVF/ICSI success. DESIGN: Retrospective clinical study. SETTING: 2nd Department of Gynaecology and Obstetrics, Medical Faculty and L. Pasteur University Hospital Kosice, Slovak Republic. METHODS: Individual parameters and clinical pregnancy rate of 232 IVF/ICSI cycles were compared in dependence on stimulation protocol (pure rFSH vs. rFSH and 75 IU rLH from S7). RESULTS: There was no statistically significant difference in IVF/ICSI success between individual groups and subgroups, but we demonstrated the increase in clinical pregnancy rate per ET in agonist cycles group with exogenous LH activity totally above 11% (27.6% vs. 38.6%), in patients under 35 years above 12% (30.4% vs. 42.6%) and in patients over 35 years above 14% (16.7% vs. 30.8%). In antagonist cycles group there was demonstrated the increase in clinical pregnancy rate only in women over 35 years - above 14% (13.3% vs. 30.8%). CONCLUSIONS: Despite of negative statistical analyses, from the clinical point of view we can strongly recommend the LH addition during COH, especially in agonist cycles and in older women.

[Risk of the prolapse "de novo" in primary unaffected compartment by using the syntethic mesh in the surgery treatment of the pelvic organe prolapse]. / Riziko vzniku prolapsu "de novo" v primárne nepostihnutom kompartmente pri pouzití syntetického implantátu v rámci operacnej liecby prolapsu panvových orgánov.

OBJECTIVE: The aim of this retrospective trial was to evaluate the risk of the prolapse "de novo" in primary unaffected compartment by using the syntethic mesh. DESIGN: Rerospective multicentric trial. SETTING: 2nd department of Gynaecology and Obstetrics, Medical Faculty of Safarik's University and L. Pasteur Hospital, Kosice and Gynaecology department, Gynpor, s.r.o., Sliac, Slovakia. POPULATION AND METHODS: One hundred and eleven women with stage > or = 2 prolapse according to the Pelvic Organe Prolapse - Quantification (POP-Q) system was enrolled into the study. In group MESH A (anterior compartment) was 86 (17x Prolift Anterior; 69x Prolift Anterior like MESH and group MESH P (posterior compartment) was 25 (9x Prolift Posterior; 16x Prolift posterior like MESH) of enrolled women. The primary outcome was the risk of POP > or = 2 "de novo" prolapse in primary unaffected compartment at 12 months follow-up. The second was the efficacy of the treatment by using synhetic mesh. Third was: Did uterus sparing operation increase the risk of reccurance of the prolapse. Complications was also reported. RESULTS: For subject attendigs the 12-month follow-up, the risk of "de novo" prolapse in MESH A group was 20.9% (17/86) compared with only 16% (4/25) in the MESH P group and was not significantly different (p<0.13). The efficacy was 91.6% in the MESH A group and 84% in the MESH P group and was not significantly different. Uterus sparing operation did not increase the risk the prolapse,,de novo" in primary unaffected compartment. Vaginal mesh exposure occured in 14.4%. CONCLUSION: Vaginal repair by using MESH is effective in the treatment of the pelvic organe prolapse, but is posible to provoke the development of prolapse in primary unaffected compartment.

[Overview of potential oncomarkers for detection of early stages of ovarian cancer]. / Prehl'ad potenciálnych onkomarkerov detekcie skorých fáz rakoviny vajecníkov.

The causes of ovarian cancer have not been fully elucidated yet but genetic predisposition is found in approximately 10% of patients. When the disease is detected at an early stage, up to 90% of patients have a hope of recovery. However, no preventive measures or precise screening tests to detect early stages of this disease are known yet. Standard tumor markers (CA125) are usually investigated in women with an increased risk. Nevertheless, due to low sensitivity and specificity during the first stage of the cancer, CA125 determination showed a very low efficacy (less than 26%). There has been a considerable progress over the recent years in understanding the molecular mechanisms leading to tumor formation and metastasis. Gradually, 46 genes were identified, initially named tumor endothelial markers (TEM), the expression of which is increased in tumors compared to normal endothelial cells. Death receptor 6 (DR6) and glycoprotein M6B (GPM6B), both detectable from patients serum, are among the most promising candidates for a marker of an early stage of ovarian cancer. This review aims to clearly describe potential as well as clinically used tumor markers useful in an early detection of ovarian cancer. Search for new markers, characterized by increased expression in patients'blood is a highly topical issue.

In vitro antiproliferative and antiangiogenic effects of Flavin7.

Flavin7 (F7) is a nutritional supplement often taken by cancer patients in Central Europe during chemo- and radiation therapy. In this study, investigation of the antiproliferative and antiangiogenic activities of this supplement were performed. Flavin7 showed antiproliferative activity in Jurkat as well as in HeLa cells. It significantly reduced the growth of both cancer cell lines at the doses of 200 microg/ml to 20 microg/ml (p<0.001 and p<0.01, respectively). In F7-treated Jurkat cells we found a significant increase in the fraction of cells with sub-G(0)/G(1) DNA content, which is considered to be a marker of apoptotic cell death. Apoptosis was also confirmed by annexin V staining and DNA fragmentation. Furthermore, F7 at the doses of 100 microg/ml to 4 microg/ml inhibited endothelial cell migration and capillary tube formation what indicates its potential antiangiogenic properties. Flavin7 also inhibited the activity of matrix metalloproteinases (MMPs), preferentially MMP-9, at the doses of 100 microg/ml to 4 microg/ml. Our data suggest that F7 possesses marked antiproliferative and antiangiogenic properties in vitro. Further research is needed to elucidate also its in vivo activities.

[Influence of exogenous supplementation with luteinizing hormone during controlled ovarian hyperstimulation on the results of IVF cycle]. / Vplyv exogénnej suplementácie luteinizacného hormónu pocas kontrolovanej ovariálnej hyperstimulácie na výsledky cyklu IVF.

OBJECTIVE: To evaluate the effect of exogenous luteinizing hormone in in vitro fertilization cycles with depot GnRH agonist and low residual LH levels. DESIGN: Prospective randomized clinical trial. SETTING: 2nd Department of Gynecology and Obstetrics, Medical Faculty and L. Pasteur University Hospital Kosice METHODS: In the prospective randomized clinical trial the effect of exogenous LH on outcomes of assisted reproduction was evaluated. The total number of 68 in vitro fertilization cycles in normogonadotrophic women undergoing assisted reproduction with GnRH agonist down-regulation and recombinant FSH controlled ovarian stimulation were included. In all cycles the low residual LH level in the middle of stimulation was detected. The cycles were randomized into three groups. The first group was stimulated with pure recombinant FSH. In the second group the exogenous LH activity in the form of human menotrophin was added. And in the third group the human recombinant LH was added. RESULTS: Better outcomes of assisted reproduction were detected in both groups with exogenous LH activity. But these results, except the dosage of FSH, were not statistically significant. The increase of pregnancy rate by more than one fifth in these both groups can be considered as clinically relevant. CONCLUSIONS: It can not be positively proved at the base of our results that exogenous LH activity in cycles with low residual LH level can improve outcomes of assisted reproduction. It could be appropriate in the future to select women that can profit from exogenous LH activity according to other parameters not only to the LH serum level.

[Endometrial thickness in postmenopausal patients with breast carcinoma--preliminary results]. / Hrúbka endometria u postmenopauzálnych pacientok s karcinómom prsníka--predbezné výsledky.

OBJECTIVE: One of the most important factors contributing to developing of the breast cancer is a female organism exposure to estrogens. Thickness and structure of endometrium in postmenopausal women is a sign of the hormonal status. The goal of the study was to investigate whether there is a difference in the endometrial thickness and quality in postmenopausal women with breast cancer. DESIGN: Prospective cohort study. SETTING: Ultrasound Unit, 2nd Department of Obstetrics and Gynecology, Medical School and Medical Teaching Hospital of L. Pasteur, Kosice, Slovakia. MATERIAL AND METHODS: Endometrial thickness was measured by transvaginal ultrasonography in 21 patients with histologically verified breast cancer and was compared with a group of 26 well women. We assessed the thickness of endometrium, the size of uterus and the endometrium/myometrium index. RESULTS: Despite the fact there existed a difference between these two groups (the average thickness of 3.6 mm and 2.9 mm), the result was not statistically applicable to show a correlation with a benign or malignant breast tissue. CONCLUSION: The results may support the theory of breast cancerogenesis in correlation with estrogen influence or increased incidence of estrogen receptors, respectively. As definitive statistical result can not be stated due to a limited group of patients, more investigation might be necessary in the future. The study dealing with a similar problem was not found in available publications.