[Uterus corpus extension of primary cervical carcinoma IIA-IIB]. / Wartosc rokownicza oceny naciekania trzonu macicy w przypadkach pierwotnego raka szyjki macicy w stopniu IIA--B.

OBJECTIVES: The infiltration of uterine body is observed in 20-43% of patients with primary cervical cancer in stage II. MATERIALS AND METHODS: A hystoclinical, retrospective analysis of 175 patients with IIA-IIB cervical carcinoma, on whom Wertheim-Meigs surgery was performed between 1972-1991, was done. Infiltration of the uterine corpus was observed in 35 patients. The presence and depth of extension of uterine corpus infiltration, presence of metastatic lymph nodes, vascular invasion and uterine vascular emboli as well as fornical and paramertial infiltration were assessed with regard to 5-year survival. RESULTS: It was found that evaluation of uterine corpus infiltration, based on our scale of depth and extension is useful for prognosis of patients (p < 0.001). CONCLUSION: In stage II of primary cervical cancer deep and extensive uterine corpus infiltration is an independent and detrimental prognostic factor.

[Uterine corpus extension of primary cervical carcinoma IIA-IIB. The compatibility of preoperative and postoperative diagnosis and its annual significance]. / Naciekanie trzonu w pierwotnym raku szyjki macicy IB--IIB. Zgodnosc rozpoznania przed- i pooperacyjnego oraz ich wartosc rokownicza.

OBJECTIVE: Evaluation of the concordance of preoperative diagnosis, based on dilatation and curettage (D&C) and postoperative diagnosis, based on specimen of uterine corpus, as well as finding if the material from D&C allows to conclude about extension of uterine corpus infiltration and thus patient's prognosis. MATERIAL AND METHODS: Analysis was done on 43 patients with uterine corpus infiltration in stage Ib-IIb of primary cervical cancer, on whom Wertheim-Meigs surgery was performed. Depth of uterine invasion in D&C material (free of cancer endometrium, cancerous endometrium, cancerous fragments of myometrium) was compared with actual postoperative assessment of uterine specimen. 5-year survival rate was also analysed. RESULTS: Statistically significant differences in depth and extension of uterine body infiltration between patients with soley endometrial infiltration and patients with infiltrated fragments of myometrium in D&C material were found. CONCLUSION: Presence of infiltrated fragments of myometrium in D&C material was mostly found in cases of extensive corpus infiltration (postoperative specimen) and it had much to do with poor prognosis.

[Co-existence of reduced femur neck density and reduced skin thickness]. / Wspólistnienie obnizonej gestosci kosci szyjki udowej i obnizonej grubosci skóry.

OBJECTIVE: In peri- and postmenopausal women, the association of skin thickness with bone mass is well described, and a low skin thickness is a useful predictor of osteoporosis. In this study the association between skin thickness and bone mass of femoral neck in peri- and postmenopausal women was assessed; and the potential for skin thickness as a screening test for osteoporosis evaluated. DESIGN/METHODS: Skin thickness was measured at the arm by ultrasonography (probe 22 MHz). Bone mass was measured at the neck of femur by dual-energy X-ray absorptiometry. One hundred and three peri- and postmenopausal women were studied. RESULT: Successive decrease of skin thickness going along with the loss of femoral neck bone mass was found. There was a statistically significant difference in skin thickness between group of females with normal bone mass and group with osteopenia (p < 0.05) and osteoporosis (p < 0.01). CONCLUSIONS: Ultrasound skin measurement is a very simple method which can be used in the diagnostics of osteopenia and osteoporosis of the neck of femur in peri- and postmenopausal women.

[The value of skin densitometry in diagnosis of decreased bone mass in the spine of women during the period around and post-menopause]. / Wartosc densytometrii skórnej w diagnostyce zmniejszenia masy kostnej kregoslupa u kobiet w okresie okolo i pomenopauzalnym.

OBJECTIVE: In peri- and postmenopausal women, the association of skin thickness with bone mass is well described, and a low skin thickness is a useful predictor of osteoporosis. In this study the association between skin thickness and bone mass of lumbar spine in peri- and postmenopausal women was assessed; and the potential for skin thickness as a screening test for osteoporosis evaluated. DESIGN/METHODS: Skin thickness was measured at the arm by ultrasonography (probe 22 MHz). Bone mass was measured at lumbar spine by dual-energy X-ray absorptiometry. One hundred and three peri- and postmenopausal women were studied. RESULT: Successive decrease of skin thickness going along with the loss of lumbar spine bone mass was found. There was a statistically significant difference (p < 0.05) in skin thickness between group of females with normal bone mass and group with osteoporosis. CONCLUSIONS: Ultrasound skin measurement is a very simple method which can be used in the diagnostics of osteoporosis of the lumbar spine in peri- and postmenopausal women.

[Primary carcinoma of the fallopian tube: a clinicopathological study of 11 cases]. / Analiza kliniczno-morfologiczna 11 przypadków pierwotnego raka jajowodu.

OBJECTIVES: Clinicopathological study of eleven cases of carcinoma of the fallopian tube to understanding possible risk factors for therapeutic failure. DESIGN: The study group consisted of 11 cases of primary carcinoma of the fallopian tube treated in our Department over 25-year period. Clinical and pathologic data were obtained from the hospital records review. RESULTS: The mean age of the patients was 57.22 years. Pelvic pain was the predominant symptom (81.8%). Three of 11 patients had the classic syndrome of "hydrops tubae profluens". On the physical examination the pelvic mass was the most frequent finding (72.7%). Five of the 11 patients had never been pregnant and five had had a single pregnancy. In all patients the diagnosis was established at the time of laparotomy. The tumor was unilateral in 72.7% of the cases with equal frequency in the left or the right tube. The tube was significantly dilated in nine patients, in two other the tumor was smaller then 10 mm. Histologically the vast majority of the tumors was papillary serous adenocarcinoma, and only in one case clarocellulare adenocarcinoma was found. The histologic grade was in 63.6% poorly- and in 36.4% moderate differentiated. In 6 patients we found evidence of salpingitis. All of the patients received postoperative adjuvant therapy: irradiation and or chemotherapy. The mean interval from diagnosis to death was 44.5 months. CONCLUSIONS: Multicenter studies are needed to improve the understanding of possible risk factors for diagnostic additionally therapeutic failure and the optimal treatment for each stage of the disease should be defined.

[Comments on reconstruction after postcricoid carcinoma surgery]. / Uwagi na temat rekonstrukcji po operacji raka czesci zapiersciennej gardla dolnego.

Within the years 1989-1999, 44 hypopharynx carcinoma operations were held. Five patients have been selected for anterior wall esophagus reconstruction with anterior part of larynx. Preservation of the esophagus posterior wall mucosa and a loss of not more than 4 cm oesophagus were the indication for this kind of reconstruction. One of the patients who underwent the operation died of metastasis within a year, two of them after three and five years because of other diseases. Two patient survived--one three years, and the other one half a year from the operation. The authors would like to indicate the functional results of the treatment.

The effect of evaporative air chilling and storage temperature on quality and shelf life of fresh chicken carcasses.

The effect of evaporative air chilling on quality of fresh chicken carcasses was compared with air chilling as reference method. Cooling efficiency and total heat loss were significantly higher for evaporative air chilling. The chilling method was of great importance for weight loss. Chicken chilled in cold air lost considerably more weight than chicken cooled by evaporative air chilling; the difference was 1.8%. The chilling method also affected the skin color and the amount of moisture on skin surface. After evaporative air chilling, the chicken carcasses had a lighter color and more water on the back and under the wings. The moisture content in skin and meat, cooking loss, and pH were not affected by chilling method. Odor attributes of raw chicken and odor and flavor attributes of cooked chicken did not show any significant differences between the two chilling methods. The shelf life of chicken stored at 4 and -1 C were not affected significantly by chilling method. Storage time and temperature appeared to be the decisive factors for sensory and microbiological quality of fresh chicken carcasses.

[The effect of total protein and albumin levels in serum on retinal detachment due to EPH-gestosis]. / Wplyw poziomu bialka calkowitego oraz albumin w surowicy krwi na przebieg odwarstwienia siatkówki w wyniku EPH-gestozy.

The purpose of the report is to describe a 31-year-old pregnant woman with EPH-gestosis presenting typical clinical features of bilateral retinal detachment. We noticed that it was associated with low degree of total protein and albumin in serum. Shortcoming protein balance was associated with adhibition of retinae. Attention is paid to the fact that elevation of retinal detachment responded to the treatment involving parenteral administration of albumin. In this case we achieved reattachment of retinae and regained full visual acuity.

[Evaluation of bacteriological research data and laboratory symptoms of infection in the diagnosis of congenital and acquired infections]. / Ocena wyników badán bakteriologicznych oraz laboratoryjnych wykladników infekcji w rozpoznawaniu zakazen wrodzonych oraz nabytych.

The predisposition of the newborns to contract infections diseases is dependent upon the limited efficiency of their immune mechanisms. Congenital infections amount to 5.7% in the research material, and the acquired infections 1.15%. The isolation of the microorganism is the basis for treating infections-the profiles of the pathogenic bacterial in flora were subjected to analysis. Im generalised infections Stafphylococcus epidermidis makes 56.6% and E. Coli accounts for 87.5 of the infections of the urinary system. In our research the late sepsis and pneumonia are more frequently the result of the hospital infection (14.2%) in the cases of congenital infections-pneumonia and the infection of the urinary system (72%). Hematologic indicators such as: leucopenia, thormbocytopenia, I/T are distinct infection markers (those were found in 31% of the cases). The CRP protein shows the lowest values in congenital infections, still monitoring its level is useful for assessing the effectiveness of the undertaken antybacterial treatment. The newborns of male sex (58%) more often prone to infection. Pneumonia is the manifestation pertaining to an organ in 70% of congenital infections, the infection of urinary system amounts to 17.1%.

[Laparoscopic image of pelvic minor organs in women after ovary surgery]. / Laparoskopowy obraz narzadów miednicy mniejszej u kobiet po przebytych operacjach jajników.

An analysis of indications to laparoscopy and an evaluation of the abdominal cavity organs in patients who earlier in their history have undergone laparotomy, is the object of this report. A group of 86 patients was studied and in all cases laparoscopy followed previous laparotomy. Infertility, PPS, and pelvic mass were found to be the most frequent indications to laparoscopy. In 74.4% of patients who had laparotomy in their history, our laparoscopy revealed pelvic adhesions and in 9.3% of patients--endometriosis. Laparoscopy constitutes safe diagnostic and therapeutic procedure, complications occurred in 2.3% of patients.

[Surgical treatment of uterine myoma: need for surgery and long-term results]. / Zachowawcze operacyjne leczenie miesniaków macicy--wskazania i odlegle wyniki.

We analysed the indications to myomectomy in females in reproductive age and estimated efficasy of this treatment. 112 patients aged 23-45 were analysed. Most common indication to this procedure were: menorrhagia--45.54%, myoma found at gynecological examination--21.43%, adnexal mass--20.54% and pelvic pain--15.18%. 54.46% patients were parous, 34.82% nulligravid and 10.72% had a history of spontaneous abortion. There was low percentage of intraoperation complications--2.67%, as well as postoperation complications--3.57%. More than 5 years follow-up revealed recurrent myoma in 14.28% females and in 6.25% hysterectomy was performed. Cervical polypus was found in 8.04%, endometrial hyperplasia in 2.68%. 18.75% patients had menorrhagia and 5.36% abdominal pain. Successful pregnancies have occurred in 42.11% infertile women prior to surgery but with patent fallopian tubes. Our study shows that myomectomy is safe and well accepted method of treatment for uterine myomas however always stands a risk of recurrents.

[The evaluation of endometrial invasion of cervical Ib grade carcinoma]. / Wartosc rokownicza oceny naciekania trzonu macicy w przypadkach raka szyjki macicy w stopniu Ib.

Depth and extension of infiltration into uterine corpus with regard to 5 years survival in 33 patients in which Wertheim-Meigs surgery was done due to cervical cancer stage Ib is estimated in this paper. Endometrial stromal invasion or depth invasion less than 1/2 of myometrium at the site of internal ostium were of similar (91.7% > 5 years survival time) as an invasion confined solely to uterine cervix (86.9% > 5 years survival). Invasion of more than 1/2 of myometrium was associated with poor prognosis (46.7% 5-years survival). Bad prognosis (16.6% 5-year survival time) in patients with deep and extensive of uterine corpus and fundus should be tied to massive infiltration increased hematogenous and lymphatic dissemination. None of patients with deep and extensive invasion, lymph nodes metastases and uterine vasa embolies did survive 5 years period of time. These patients need individual postoperative adjuvant therapy.

[Vascular invasion and prognostic factors in cervical Ib grade cancer without metastases in lymph nodes]. / Inwazja naczyn a rokowanie w raku ograniczonym do szyjki macicy (Ib) bez przerzutów do wezlów chlonnych.

We were looking for presence, severity and extension of the invasion of vessels, with regard to the prognosis in 275 patient with infiltration limited only to uterine cervix (Ib), in which Wertheim-Meigs surgery was performed. It was found invasion of many vessels- in outside of the cervix is associated with poor prognosis, no matter weather the local lymph nodes are metastatic or not and no matter what the size of the neoplastic infiltration is. Patient with severe and extensive vascular invasion require further postoperative treatment.

[Cervical cancer Ib associated with pregnancy]. / Inwazyjny rak szyjki macicy w ciazy.

An analysis of symptoms, diagnostic methods, intra- and postoperative complications in 17 pregnant patients in which Wertheim-Meigs operation was done due to stage Ib cervical cancer, is presented in this report. The most common symptoms were contact bleeding and spotting (58.8%) as well as pathologic vaginal discharge (29.4%). 3 patient did not have any symptoms in their history. No bleeding occurred in patients in whom probatory specimen was taken from their cervix. Small 7-12 days spotting appeared in 2 out of 3 patients following diagnostic conisation, done in case of ca in situ or microinvasive cancer. Pregnancy as a such was never a cause of intraoperative difficulties or complications. Mean blood transfusion was 1250 ml, this is 150 ml more than in nonpregnant patients. Most frequent postoperative complication was retentio urinare (47%). 5-year survival rate of pregnant patients (82.3%) was worse than in nonpregnant patients (96.2%) in the same age group and in comparable expansion of cancer in stage Ib in postoperative histological evaluation.

[Cervical cancer and pregnancy: prognostic value of immunological response in nodes and cancer stroma]. / Wartosc rokownicza immunologicznych odczynów komórkowych w podscielisku raka i w regionalnych wezlach chlonnych u ciezarnych z inwazyjnym rakiem szyjki macicy Ib.

Immune response in the stroma of cancer and in regional lymph nodes with regard to 5-years survival rate in 17 pregnant patients in which Wertheim-Meigs operation due to Ib cervical cancer was done, is assessed in this paper. Activation and hyperplasia of T and B dependent layers of lymph nodes as well as infiltration by monocyte-macrophage and lympho-plasmatic mature, immunocompetent cells are related to good prognosis and these are most frequent in patients with small invasion. Lack of immune response in lymph nodes, its poor expression, hemolymphatic transformation, adiposis of nodes or their fibrosis was found in 5 patients; 3 of them died within 5 years. Scare monocyte-macrophage infiltrations and low-differentiated lymphocytes prevailed in the stroma of cancer. Inactive answer in nodes and in stroma was found in 8 out of 12 patients who had deeper infiltration than 0.5 cm. Immunologic response in nodes and in stroma should be assessed as a routine method for all prognostic purposes. Patients with inactive immunologic response should be qualified for further treatment.

[Balneologic rehabilitation in women operated on for ectopic tubal pregnancy]. / Rehabilitacja balneoterapeutyczna u kobiet operowanych z powodu ciazy ektopowej jajowodowej.

This paper is in support of balneological rehabilitation in patients operated on due to ectopic pregnancy and still willing to have children. In a group of 203 patients, in which histopathological findings from the material obtained at the time of surgery enabled determination of the cause of ectopic pregnancy, causative pharmacological treatment was established. Than the successive balneological treatment was carried out in 74 out of these 203 patients. Our data shoved that patients who underwent balneological rehabilitation after surgery tended to become pregnant two times more often, number of repeated ectopic pregnancies was just inconspicuous and the preservation of the patency of operated Fallopian tubes was also two times higher.

[Results of treating tubal factors in infertile women in light of successful pregnancies]. / Wyniki leczenia czynnika jajowodowego u kobiet nieplodnych w swietle uzyskanych ciaz.

We retrospectively analyzed 80 pregnancies ended by delivery of a healthy child in women after treatment of tubal infertility. The results were influenced by the duration of infertility, duration of the treatment and by the age of the patients. 13.75% of women with clinical symptoms of chronic exacerbate inflammation became pregnant after preliminary anti-inflammatory treatment but 86.25% of women following treatment due to earlier determined etiology (endometriosis, post inflammatory tubal disease). The group of women (38.75%) with oviductal occlusion apart from the treatment based on etiology were also treated surgically in 70%.

[Fertility of women after past ectopic pregnancy]. / Plodnosc kobiet po przebytej ciazy ektopowej.

An analysis of the fates of women after passed pregnancy was performed concerning the type of surgery and the microscopic findings in the excised oviducts. The analysis based on the subsequent frequency of intrauterine pregnancies in the operated subjects, incidence of repeat ectopic pregnancies and following sterility. In the group 416 operated women intrauterine pregnancy followed in 31.2% and ectopic pregnancy--in 8.9%, secondary sterility was noted in 29.6%. The performed surgical interventions were analysed in 4 subgroups depending on the range of surgery. A higher rate of intrauterine pregnancies was seen in women after unilateral salpingectomy or unilateral reconstructive-conservative operation. Higher incidence of ectopic pregnancies was seen in women undergoing unilateral salpingectomy and recanalization of the other oviduct. Analysis of the microscopic findings revealed a higher incidence of intrauterine pregnancies in women demonstrating functional changes in the operated oviduct, versus a lower one in those, with inflammatory or endometriosis process in the affected oviduct. No differences could be found--correlated with the microscopic diagnosis.

[Diagnostic methods considering tubal factors in infertility]. / Metody diagnostyczne czynnika jajowodowego nieplodnosci.

The diagnostic methods of tubal factor in infertility have been presented in this paper. In details have been discussed PJ, PK, HSG and pelvic examination. These examinations themselves constitute the basic ones in infertility. We turned our attention into technical details and possible mistakes which may occur at the time of performing them, these misinterpretations may lead to absolutely wrong conclusion and diagnosis. Authors have wide experience in performing the discussed examinations and this allows them to share their opinions. Over the years several thousand of PK and HSG examinations have been carried out and also 1000 laparoscopies.

[Psychophysical examinations of adolescent girls with neoplastic diseases during puberty after multidrug chemotherapy]. / Badania psychofizyczne dziewczat z choroba nowotworowa w okresie pokwitania, po zakonczeniu chemioterapii wielolekowej.

We estimated the psychosomatic development of 25 girls aged 13-19 years after antineoplastic therapy. Normal parameters of physical development were stated in all cases. No injury of central nervous system in all cases was seen. Psychological examination revealed strong suppression reactions and evident anxiety signs in majority of girls.