Endometriotic lesions mimicking advanced ovarian cancer - A case report and a review of the literature.

BACKGROUND: Approximately 2-5% of women affected by endometriosis are postmenopausal. The disease may simulate various malignancies. A case of endometriosis in a postmenopausal woman, spreading similarly to ovarian cancer, is reported. A broad review of existing literature on postmenopausal endometriosis, endometriosis involving the urinary tract, and the links between endometriosis and cancer are also presented. CASE DESCRIPTION: A 51-year-old woman was diagnosed with a pelvic mass. She complained of pain in the lower abdomen that began three weeks prior, and had no history of dysmenorrhea, acyclic pelvic pain, or infertility. CT scan revealed a solid and cystic tumor in the region of the right adnexa, infiltrating the surrounding tissues, with possible infiltration of the urinary bladder, as well as soft-tissue lesions of the small intestinal mesentery. Bilateral hydronephrosis and distension of the ureters were also present. A malignant neoplasm of the ovary or the corpus uteri was suspected. Total abdominal hysterectomy and appendectomy were performed. A superficial infiltration of the urinary bladder was also excised. The pathology report revealed endometriotic foci in the tumor and in the bladder infiltration, as well as an endometriotic cyst in the right ovary. Two years postoperatively the patient is disease-free and in good condition. CONCLUSIONS: Clinicians should remain conscious of the possibility of endometriosis mimicking advanced ovarian cancer and infiltrating the peritoneum and internal organs of the abdominal cavity, including the urinary tract. Imaging techniques, including CT and MRI, are not always effective in establishing the correct diagnosis preoperatively.

Respiratory Function and Language Abilities of Profoundly Deaf Adolescents with and without Cochlear Implants.

The objective of the study was to investigate whether hearing loss has an effect on the ventilatory functional capability and whether possible deviations of ventilatory variables from the reference ranges could have to do with the language abilities of deaf adolescents. Spirometric evaluations were performed in 72 prelingually profoundly deaf adolescents with and without cochlear implants (CI) and compared with the results of a control group consisting of 48 participants with normal hearing (CG). The deaf adolescents showed a significantly lower vital capacity (VC), forced vital capacity (FVC), and expiratory flows (PEF and MEF) compared with their hearing peers. The adolescents with CI demonstrated predominantly the oral communication mode, which however did not affect the students' education achievements. Perseverance of oral communication was also associated with higher FVC and PEF, compared with deaf participants without CI. We conclude that sensory deprivation of prelingually deaf adolescents affects the respiratory system function. The use of oral communication seems to have beneficial effects on respiratory performance in profoundly deaf adolescents.

Blood metabolic response to a long-term wheelchair rugby training.

STUDY DESIGN: A cross-sectional study with comparison group. OBJECTIVES: To evaluate the effects of long-term wheelchair rugby (WR) training on lipid profile, blood antioxidant status and the brain-derived neurotrophic factor (BDNF) level. SETTING: Academy of Physical Education, Katowice, Poland. METHODS: Thirty-two males with chronic cervical spinal cord injury (SCI) assigned into the physically active 'low-point' (LP, n=15) or 'high-point' (HP, n=8) WR players groups and the sedentary manual wheelchair users (SED, n=9) participated in this study. Fasting blood samples were collected at rest for assessment of activities of antioxidant enzymes, concentrations of reduced glutathione, uric acid, malondialdehyde (MDA), lipid profile measures and BDNF. RESULTS: No significant differences were found in anthropometric measures and serum lipid profile indices, although a slight tendency toward higher high-density lipoprotein cholesterol level was evidenced in WR players. Significantly lower serum malondialdehyde (MDA) and significantly higher levels of the overall enzymatic antioxidant potential index (EAP) in WR players, compared with SED, may reflect some WR training-induced increase in the blood's antioxidant capacity. There was also a slight tendency toward higher serum BDNF level in WR players compared with the SED group and a significant positive association between years of WR training and the BDNF level. CONCLUSION: A voluntary participation in a long-term WR training program has several health promoting outcomes for individuals with chronic SCI. Among the most important are enhancement of the blood antioxidant defense capacity evidenced by lower MDA and higher EAP levels, as well as WR training-induced activation of BDNF signaling.

Postradiation carcinosarcoma of the corpus uteri--a case report.

INTRODUCTION: Radiation therapy is a very effective treatment modality, commonly used for numerous gynecological malignancies, e.g. cervical cancer. Unfortunately, ionizing radiation is associated with numerous side effects, including secondary cancer formation. A case of carcinosarcoma of the corpus uteri in a woman with a history of pelvic irradiation for cervical carcinoma is reported. The literature has been reviewed to present the incidence, optimal management, and prognosis in cases of postradiation uterine carcinosarcoma. CASE: A 55-year-old woman with a history of pelvic radiotherapy for cervical cancer five years earlier was diagnosed with a pelvic mass. Endovaginal ultrasound examination revealed a solid and cystic tumor, 12.5 cm in diameter. The patient was scheduled for surgery. Gross examination revealed an enlarged, plain corpus uteri, 12 cm in diameter. Both adnexa were normal. Pelvic and abdominal peritoneum were macroscopically normal and normal on palpation. Iliac and obturatory lymph nodes were enlarged on both sides. Radical hysterectomy, omentectomy, and ilio-obturator lymph node dissection were performed. The pathology report revealed carcinosarcoma of the corpus uteri with lymph nodes metastases--FIGO IIIC1. No adjuvant treatment was given. The patient is still alive and disease-free one year after surgery. CONCLUSIONS: Clinicians should.remain conscious of the potential carcinogenic effect of radiation therapy. Uterine carcinosarcoma may occur years after radiotherapy applied for cervical cancer. Therefore, long-term control following pelvic irradiation is always necessary.

Evaluation of selected markers of the immune system in children of renal transplant recipients.

OBJECTIVE: The aim of this study was to evaluate whether chronic use of immunosuppressive drugs during pregnancy in women after renal transplantation affects the concentration of immunoglobulin G (IgG) and IgM in the serum of their children. MATERIAL: Seventy-eight children aged 1 day to 15 years were enrolled. The study group consisted of 39 children born to renal transplant recipient mothers. The control group comprised 39 children whose mothers had not received immunosuppressive medications during pregnancy and were born at similar gestational age. METHODS: Serum concentrations of IgG and IgM were evaluated with the use of agglutination immunoassays on Siemens or Cobas device. Age-adjusted reference values for immunoglobulins formulated by Wolska-Kusnierz et al were used. Statistical analysis was performed with the use of Statistica 10.0 software with P value <.05 considered significant. RESULTS: Normal IgG concentrations were found in 82.05% (32) of children from the study group and 79.49% (31) of the control group. IgG concentrations below normal range were observed in 12.82% (5) of children from the study group and in 15.38% (6) of the control group. Normal concentrations of IgM were found in 53.85% (21) of children from the study group and in 61.54% (24) of the control group. Decreased levels of IgM were observed in 38.46% (15) of children from the study group and 35.9% (14) of the control group. There were no significant differences regarding the analyzed values between the groups. CONCLUSION: The exposure to chronic intrauterine immunosuppression had no significant effect on the concentration of IgG or IgM in children born to kidney transplant recipients.

Spirometric measurements and physical efficiency in children and adolescents with hearing and visual impairments.

The objective of the study was to investigate whether a sensory impairment has an effect on functional capabilities of the respiratory system and whether possible deviations from reference ranges of selected parameters might indicate a decrease of physical efficiency. Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), forced expiratory flow of 25-75% (FEF25-75), maximum voluntary volume (MVV), and maximum oxygen uptake VO2 max were measured in 86 deaf and 102 blind children and adolescents, and in a matched group of hearing controls. We found a significant influence of deafness on PEF (P<0.01), FEF25-75 (P<0.05), and MVV (P<0.05). As compared with the control subjects, mean VC was significantly lower in blind adolescents (P<0.05). Our results seem to suggest that both sensory defects during childhood and adolescence affect functional capabilities of the respiratory system.

Spirometric values and aerobic efficiency of children and adolescents with hearing loss.

Vital capacity (VC), forced expiratory volume in 1 s (FEV(1)), peak expiratory flow (PEF), mean forced expiratory flow (FEV(25-75)), and maximum voluntary volume (MVV) were measured in 36 girls and 36 boys with hearing loss and compared with the same number of normal healthy children, all subjects were aged 10-16 years. They participated in an exercise test to calculate VO(2 max) in order to determine their physical efficiency. We found that all spirometric indices tended to be lower in deaf children, in all age-groups studied and irrespective of gender, compared with their hearing counterparts; the differences assumed significance with respect to PEF and MVV (P<0.05). Moreover, some deaf children had an appreciably lower level of VO(2 max) compared with hearing children. Our results demonstrate that sensory deprivation of deaf children affects functional capabilities of the respiratory system.