Esophageal varices during pregnancy in the course of cirrhosis.

Esophageal variceal bleeding is one of the most severe complications that may occur during pregnancy in patients with liver cirrhosis. It may result in death of the mother and the fetus. Therefore, screening endoscopy should be performed both before the conception and in the second trimester. Endoscopic band ligation is a method of choice in case of variceal bleeding. Close cooperation of hepatologist, obstetrician-gynecologist and endoscopist is recommended in order to provide maximum care and increase the chances of successful delivery. We present a case of 28-years-old primigravida, at 27 weeks pregnant with esophageal varices and liver cirrhosis.

Nitrogen metabolism in rats with experimental diabetes during acute alcohol intoxication.

The concentrations of urea and uric acid increased, while the content of free amino acids decreased in blood serum from rats with alloxan-induced diabetes during acute alcohol intoxication. Activities of glutamate dehydrogenase, AMP deaminase, and tyrosine aminotransferase in the liver of experimental animals increased.

[Chemical substances used in plastics intended for manufacture of food packaging in light of European Union legislation]. / Substancje chemiczne dozwolone do tworzyw sztucznych przeznaczonych do wytwarzania opakowan zywnosci w swietle ustawodawstwa Unii Europejskiej.

In the EU countries the use of the chemical substances for plastics intended to come into contact with foodstuffs is regulated by Directive 89/109/EEC and the several specific Directives. Positive lists of the chemical substances for plastics intended to manufacturing of food packaging are placed in Directive 90/128/EEC on plastics materials. This 90/128/EEC Directive so-called "Monomer Directive" has been amended five times by Directives 92/39/EEC, 93/9/EEC, 95/3/EC, 96/11/EC and 99/91/EC. Directive 90/128/EEC so-called "Monomer Directive" provides: list of monomers and other starting substances that can be used in the manufacture of plastics materials and articles, placed in two Sections (A and B), and list of additives initiated from Directive 95/3/EC. Other additives will be added to this list on the basis of their positive national regulatory status in the EU countries and limits of migration (global, specific). According to the EU legislation all the substances before placing on the positive lists are the evaluated and authorized by the scientific bodies (SCF and/or JECFA). The EU legislation on the plastics materials and articles intended to come into contact with foodstuffs will be implemented into Polish law. However all the regulations relating to the chemical substances and limits of migration (global and specific) are already accepted by the National Institute of Hygiene.

[Health quality criteria and the analytical procedures for the evaluation of pacifiers]. / Kryteria oceny jakosci zdrowotnej oraz procedury badania smoczków.

The health quality criteria for the evaluation of soothers for babies and young children have been developed and the analytical procedures were collected and indicated for the evaluation purposes. They include: sensory analysis global migration migration of metals (Sb, As, Ba, Cd, Pb, Cr, Hg, Se) to 0.07 M HCl analysis of volatile compounds chemical demand for oxygen presence of reaction accelerators presence of antioxidants The requirements concerning mechanical and chemical parameters and also general safety of the product have been developed and the procedures for the conformity checking of these parameters, based on Polish Standard and the draft project of European Standard EN 14000 series concerning soothers for babies and small children have also been presented. These criteria have been accepted by the Ministry of Health and Social Welfare as suitable for issuing of health certificates for placing on the market as well as for the current sanitary surveillance of soothers taken from the market. The criteria will be obligatory until the EN 1400 Standards come into force being introduced into Polish legislation.

Evaluation of DNA content and proliferative activity in prediction of short-term relapses in mammary carcinoma: a prospective study.

DNA content according to six various ploidy classes was analysed by flow cytometry on fresh tumor tissue in 701 unselected, consecutive breast cancers. Age, menopausal status, tumor size, histology and in particular nodal status were also taken into consideration. Diploid and nondiploid mammary carcinomas differed significantly in values of proliferative indicators. In node positive patients nondiploid tumors were more frequent. In node negative and node positive breast cancer patients tumor grade strongly influenced disease free survival and in the last group hypertriploidy (1.6 < DI < or = 1.8) was also an independent prognostic factor. The combination of tumor grade and hypertriploidy permitted differentiation of three groups of node positive patients, differing in the risk of relapses.

[A review of the European community directives relating to materials and articles intended to come into contact with food products in the light of Polish legislation]. / Przeglad dyrektyw unii europejskiej dotyczacych materialów i wyrobów przeznaczonych do kontaktu z zywnoscia w swietle Polskiego ustawodawstwa.

The integration of Poland with the European Community makes the harmonization of Polish legislation necessary. Among numerous Directives, which provisions should be introduced into domestic legislation before Poland enters the European Union, the Directives related to materials and articles intended to contact with food consist a large group. The review and analysis of 17 Directives that appeared up to the end of year 1997 have been done. The list of these Directives is shown in the Table I. The framework Directive 89/109/EEC on the approximation of the laws of the Member States relating to materials and articles intended to come into contact with foodstuffs have been comprehensively discussed together with the specific Directives concerning the following matters: symbol which should accompany the materials and articles intendet to contact with food: Directive 80/590/EEC; plastics materials: Directive 90/128/EEC with later ammendments provided by the Directives: 90/128/EEC, 93/9/EEC, 95/3/EC and 96/11/EC; vinyl chloride monomer (acceptable limit and analytical method): Directives: 78/142/EEC, 80/766/EEC and 81/432/EEC, regenerated cellulose film-Directives: 93/10/ECC i 93/111/EEC; ceramic articles: Directive 84/500/EEC; testing migration of constituents of plastic materials-Directives: 85/572/EEC and 82/711/EEC with later ammendments: Directives: 93/8/EEC, 97/48/EC, The relevant Polish regulatory provisions concerning the matters related to materials and articles intendet to contact with foodstuffs have also been discussed. The need for harmonization of Polish regulations with the relevant legislation adopted by the Member States of the European Community was emphasized.

Prognostic assessment of histologic parameters in breast carcinomas: a prospective study.

A group of 350 unselected breast cancer patients, treated at the Center of Oncology in Cracow, Poland, between January 1992 and December 1994, was analyzed. The following reciprocally interrelated histologic characteristics were evaluated: 1) histologic tumor type (considered in 3 categories of aggressivity), 2) tumor grade (according to Scarf-Bloom-Richardson), 3) constituent of in-situ carcinoma in invasive cancers and characterization of breast lobuli, 4) tumor growth pattern (microfocal, macrofocal or mixed), 5) invasion of nerves, 6) vascular invasion by cancer cells in tumor surroundings, 7) extensiveness of tumor necrosis, 8) involvement of the breast distant from the tumor mass by cancer cells, 9) status of axillary lymph nodes, 10) invasion of metastatic lymph node surroundings. Metastases in axillary lymph nodes were independently influenced by vascular invasion in tumor surroundings and tumor diameter. The disease-free survival was independently influenced by tumor diameter, necrosis and stage of the disease (pTNM), whereas total survival related to tumor diameter, nodal status, microfocal pattern of tumor growth, vascular invasion and involvement of breast by cancer distant from the tumor mass was independently influenced only by tumor stage (pTNM).

[Adenoid cystic carcinoma of the breast. Analysis of 7 patients]. / Rak gruczolowo-torbielowaty gruczolu sutkowego. Analiza 7 chorych.

A retrospective analysis of 7 patients with adenoid cystic carcinoma of the breast operated at Center of Oncology in Kraków is presented. Ten years without evidence of disease survived 6 (85.7%) patients. One patient only, with poorly differentiated carcinoma, presented axillary metastases and died of metastases to the lungs and hepar.

[Infiltrating lobular carcinoma of the breast. Clinical picture, treatment and prognosis]. / Naciekajacy rak zrazikowy sutka. Obraz kliniczny, leczenie i rokowanie.

An analysis of 80 patients with infiltrating lobular carcinoma of the breast treated at Center of Oncology in Kraków is presented. All patients underwent radical mastectomy. The evaluation of treatment results showed stage, pathological tumor size, and involvement of axillary nodes as the prognostic factors. The ten-year survival rate NED in all group was 38.8%; for stage I, II, and III it was 62.5%, 48.8%, and 19.4% respectively.

[Hygienic evaluation and analytical methods for the silicon rubber rubber intended to come into contact with food. Part I. Determination of the migration of the soluble substances into the aqueous model fluids]. / Zasady oceny higienicznej i metody badan gumy silikonowej stosowanej do kontaktu z zywnoscia cz. I. Oznaczanie substancji rozpuszczalnych w wodnych plynach modelowych.

The review of the regulations for the silicon rubber intended to come into contact with food in some European countries and USA was performed. On the basis of these regulations the principles of the hygienic evaluation and the analytical models for the testing of silicon rubber and elastomers contacting with food in Poland was presented. The testing include: sensoric analysis; migration of the soluble substances into aqueous model fluids; volatile substances; hardeners; catalyzers; migration of certain heavy metals; N-nitrosamines and N-nitrosatables. Some of these methods have been published in Polish Standards or in the Methodical Publications of the National Institute of Hygiene.

Multimodality treatment of noninflammatory stage IIIb breast cancer.

BACKGROUND AND OBJECTIVES: The 1990s have established the contribution of multimodality therapy in the management of IIIb noninflammatory breast cancer (IIIb NIBC), by reducing the odds of recurrence and death. METHODS: A total of 300 women with IIIb NIBC received a multimodality therapy. The treatment consisted of neoadjuvant chemotherapy [FAC (5-fluorouracil, Adriamycin, cyclophosphamide) regimen], radical (Halsted) mastectomy or modified (Patey mastectomy), postoperative radiotherapy, and adjuvant chemohormone therapy [FAC regimen + cyclophosphamide, 5-fluorouracil and methotrexate (CMF) regimen or Tamoxifen]. RESULTS: Complete or partial clinical response (CR or PR) after neoadjuvant chemotherapy was obtained in 83% patients. Ninety-nine patients (33%) survived 5 years without evidence of disease (NED). The uni- and multivariate analyses factors that had significant influence on the treatment results were: clinical response to neoadjuvant chemotherapy, pathological tumor size, and microscopical status of the axillary lymph nodes. CONCLUSIONS: We conclude that neoadjuvant FAC regimen chemotherapy is very effective in producing objective tumor regression and offers the benefit of radical mastectomy to patients with previously unresectable IIIb NIBC.

Assessment of proliferative activity, DNA values and some clinicopathologic parameters in mesenchymal tumors. Immunohistochemical and flow cytometric study.

Clinicopathologic parameters of 70 consecutive mesenchymal tumors from 63 patients were evaluated. In all these cases, the DNA content was analyzed by flow cytometry, and the expression of proliferative antigen MIB1 and p53 protein was assessed by immunohistochemistry. Our study verified the prognostic usefulness of proliferative indicators, above all MIB1-index, which strongly correlated with tumor grade and independently influenced overall survival.

[20-year survival in women with breast cancer]. / 20-letnie przezycia kobiet chorych na raka sutka.

We analysed 170 women with carcinoma of the breast who survived 20 years after local or loco-regional therapy, without adjuvant chemo-hormonotherapy. Patients with axillary lymph nodes metastases constitute thirty-six percent of this group.

[Prognostic factors in gastric lymphoma]. / Czynniki rokownicze w chloniaku zoladka.

Stomach is the most common site of extranodal lymphoma, but lymphoma's biology differs from other types of gastric cancer. From 1982 to 1994, 80 cases of primary gastric lymphoma were treated in Cancer Center in Kraków. In order to assess the best mode of treatment the retrospective analysis of disease related parameters was performed. Sixty four patients were primary treated with surgery, and 11 with radiotherapy. After surgery 21 patients received adjuvant chemo or radiotherapy. Radical resection of tumor was done in 37 cases, in next 25 only palliative surgery was possible. There was 28 cases of lymph node metastases in resected specimens. At 5 years, the overall survival was 64.4% with the median survival of 43 months. Patients primarily treated with surgery had better 5--years survival rates compared with others (72.1% and 36.8%, respectively-p < 0.05). The chance of survival was related with the tumor grading and 5 years survived 86.5% patients with well differentiated lymphomas, and 52.6% patients with nondifferentiated tumors. There was no influence on survivals other variables as duration of symptoms, type of surgery, histological margins or adjuvant therapy. The Cox multivariate analysis showed the grading, type of first treatment and lymph node status as the only three significant factors related to survivals. The relative risk of death for nondifferentiated lymphomas was 7 times higher, than for well differentiated tumors. The primary surgery (even nonradical) of gastric lymphoma is the best mode of treatment and the grading is the most important prognostic factor influencing the survivals.

The treatment and prognosis of patients with phyllodes tumor of the breast: an analysis of 170 cases.

BACKGROUND: The study addresses the controversial prognostic and therapeutic aspects of phyllodes tumor of the breast. METHODS: Records of 170 women with phyllodes tumor of the breast were reviewed. On the basis of the criteria proposed by Azzopardi and Salvadori et al., including estimation of tumor margin, growth of the connective tissue component, mitoses, and cellular atypia, the entire series was divided into three histotypes of phyllodes tumor, i.e., benign (92 cases, 54.1%), borderline (19 cases, 11.2%), and malignant (59 cases, 34.7%). Ninety-eight patients (57.6%) were treated by wide local excision (79 benign, 15 borderline, and 4 malignant), 43 (25.3%) by simple mastectomy (13 benign, 4 borderline, and 26 malignant), and 29 (17.1%) by radical mastectomy (all malignant). RESULTS: Of the 170 treated patients, 141 (82.9%) survived 5 years without evidence of disease. In the Cox multivariate analysis the histotype of the tumor was the only independent prognostic factor: 5-year NED survival was observed in 95.7% of the patients with benign phyllodes tumor, 73.7% with borderline phyllodes tumor, and 66.1% with malignant phyllodes tumor. After a wide local excision 98.7% of the patients with benign tumor, and 80% with borderline tumor, were cured. Local recurrence was found in 14 patients (8.2%) (4 benign, 3 borderline, and 7 malignant); 10 of these underwent reoperation (7 wide local excision, 3 radical mastectomy) and survived 5 years NED. CONCLUSIONS: The histotype of phyllodes tumor (benign, borderline, and malignant), assessed on the basis of the criteria proposed by Azzopardi and Salvadori et al., was the only prognostic factor in our group of patients. Based on the data from literature and our own observations, we observed that a wide local excision, with an adequate margin of normal breast tissue, is the preferred initial therapy for phyllodes tumor of the breast.

[A method of determining global migration from plastic packing materials into model fluids simulating food products containing fat according to directives of the EWG Commission]. / Metodyka oznaczania migracji globalnej z tworzyw sztucznych do plynów modelowych imitujacych srodki spozywcze z zawartoscia tluszczu z opakowan, zgodnie z zaleceniami Komisji EWG.

A method is described for determination of global migration into model fluids simulating food products with fat of isooctane, 50% and 96% ethanol from 33 samples of foils and laminates used for food packing. Bag, chamber, immersion and padding methods were used. Most samples complied with the requirements of the EEC Directives and the used method is simple and convenient. It should be introduced promptly for routine control of packing materials in the laboratories of the Province Sanitary-Epidemiological Stations.

Typical medullary carcinoma of the breast: a clinical and pathological analysis of 52 cases.

Fifty-two women with typical medullary breast carcinoma, diagnosed according to criteria of Ridolfi et al. [Cancer 40:1365-1385, 1977] are described. At the time of diagnosis, 90% of the patients were stages I and II. The primary tumor size was < or = to 4 cm in 46 (88.5%) and > 4 cm in 6 (11.5%) patients. Axillary lymph nodes were microscopically negative in 35 (67.3%) and positive in 17 (32.7%) patients. All 52 women underwent the Patey operation. Seventeen patients with microscopically positive axillary lymph nodes received postoperative irradiation. Of the 52 treated patients, 44 (84.6%) survived 10 years NED. The only prognostic factor was the microscopical axillary lymph nodes status. In the group of pNO patients, 97.1% survived 10 years NED, pN+ 58.8% only. The sole causes of unsuccessful treatment were distant metastases to lungs, hepar, and bones. Typical medullary carcinoma is a favorable histological type of breast carcinoma with very good prognosis for pNO patients.

Phyllodes tumor of the breast.

PURPOSE: Presentation of the microscopical and clinical findings, prognostic factors and principles of treatment of the phyllodes tumor of the breast. PATIENTS AND METHODS: This paper reviews the published data on this rare and intriguing tumor of the breast. RESULTS AND CONCLUSIONS: The main prognostic factor is the histotype of the phyllodes tumor (benign, borderline, malignant) assessed on the basis of the criteria proposed by Azzopardi [3] and Salvadori et al. [50]. Wide local excision with an adequate marg in of normal breast tissue is the preferred initial therapy for phyllodes tumor. Mastectomy is indicated only for very large tumors compared with breast morphologic size and for recurrences of borderline and malignant tumors.

Relationship of histology, DNA-values and proliferative activity in unselected breast cancer patients (a preliminary study).

Based upon a group of 108 consecutive mammary carcinomas a comparative analysis of morphological parameters, DNA-ploidy and indicators of proliferation activity was made. A correlation between Bloom-Richardson scale, mitotic index, PCNA-labeling index and DNA-index was shown. The ploidy of mammary carcinomas was significantly related to the values of proliferative fraction, as well as to PCNA-labeling index. Among patients with axillary metastases the tumor size and the value of PCNA-labeling index were significantly higher than those in patients with negative lymph nodes.

Flow cytometric evaluation of Ki67 proliferative antigen in primary breast cancer.

In the group of forty five primary mammary carcinomas Ki67 reactivity was evaluated with flow cytometry and immunohistochemistry. The expression of proliferative antigen, evaluated with both methods did not correlate with other indicators of proliferative activity. This result is probably associated with the physicochemical properties of breast cancer cells.