[HPV 16 in lymph nodes of the lesser pelvis in women with cervical cancer]

HPV 16 was detected in cancer tissue, blood and pelvic lymph node of cervical cancer patients. The role of these discovery is discusses.

[Conservative treatment of two young women with cancer and precancerous lesions of the endometrium]

Two women with endometrial cancer and precancerous lesion treated with medroxyprogesterone are presented. In both patients outcome of neoplasm is obtained.

[Partial excision of the anterior uterine wall for placenta accreta]

Rapid accumulation of blood from placental separation site during cesarean delivery for placenta accreta obscures the surgical field and quickly leads to deterioration of the patient's vital signs. In turn, these conditions such as uterine rupture, placenta previa, placenta accreta, increase the risk of hysterectomy, blood transfusions and prolonged hospital stay. We used the following technique in one case of intractable bleeding during cesarean for placenta accreta. Following failure to control the bleeding by suture at the placental separation site via the lower segment cesarean incision, the lower uterine segment with the abnormal adherence of placenta to myometrium, was excised. Our experience suggests that this technique could reduce the use of hysterectomy in cesarean for some cases of placenta accreta.

[Diagnosis and treatment outcome in patients with grade Ia neoplasms of the uterine cervix]

The material collected from 449 women with cervical cancer Ia was carefully studied (359 women with Ia1, and 90 with Ia2). All the methods and results of treatment were presented. 5-years survival after treatment was obtained in 93% of women.

[Ovarian gonadal tumor and reproduction in women]

Seven young patients with ovarian gonadal tumor treated conservative operation are presented. The attention to clinical and pathological difficulties is drown. The treatment advantage these patients at Gynecologic Institute with pathological department is emphasized.

[Small cell carcinoma of the ovary]

Three cases of small cell carcinoma of the ovary are presented. Attention to diagnostic difficulties, extremely aggressive course and low sensitivity to oncologic treatment was paid.

[Usefulness of transvaginal ultrasound and hysteroscopy in diagnosing endometrial hyperplasia and endometrial carcinoma]

Modern methods enabling evaluation of endometrium in all phases of the menstrual cycle were presented. Transvaginal ultrasound does not give characteristic pictures. The most frequently observed sonographic features in endometrial hyperplasia and endometrial carcinoma were compared. Most frequently, in 29% we observed the thickening of the endometrium. The enlargement of the uterine body was detected in 27%. The dominant feature in endometrial carcinoma was distortion or lack of medium-focus echo-90%. Different echogenicity was observed in 69% of all cases. Application of hysteroscopy enables us to visualize changed endometrium and also to sample focal lesions for histopathological examination. Endometrial carcinoma was detected in all analyzed cases with application of hysteroscopy and ultrasound. Pathological endometrial hyperplasia was diagnosed by ultrasound only in 44% and with application of hysteroscopy in 84% of all material.

[Diagnostic and therapeutic procedures in preinvasive disease of the cervix and cervical cancer in pregnancy]

154 pregnant women with dysplasia and cervical carcinoma of the uterus treated in the Institute in years 1953-1990 underwent investigation. We notice that only 50 pathologies were diagnosed in I trimester of pregnancy and 85% constituted precancerous and early forms of carcinoma of the uterine cervix. Authors presented the model of management and care of pregnancy, labour and puerperium in these patients. Due to this procedure we obtained 90% compatibility of preliminary and final diagnosis.

Gonadoblastoma: structures and background of development

Based on earlier studies relative to development and maturation of human gonads, a hypothesis is presented, namely, that the production of "psammoma bodies" in gonadoblastoma, as well as intensification of calcification and hyalinization processes, may be an expression of recapitulation of the involution phase of the indifferent gonad and the terminal phase of proliferating activity in the sex cords of such lesions. It is also suggested that pathologic structures found in the medulla of the ovaries of fetuses and newborn infants favor the development of gonadoblastomas and that the latter are formed as the result of dysfunction of a genetic system controlling gonadal maturation and thus are not "neoplasms."

Evaluation of germ cells development in gonads of human fetuses and newborns

Germ cells development at particular stages of gonad differentiation during the period of fetal intrauterine life were investigated. The study was performed on 101 ovaries obtained from 76 fetuses and neonates. The earliest ovary obtained was from a 12-week old fetus, the oldest one was from a full-term fetus. The examination of germ cells was based on the analysis of the morphology and enzymatic activity. The morphology of the cells was studied by the use of light and electromicroscopy. In germ cells development three forms were distinguished: gonocytes, oogonia and oocytes. Gonocytes were observed in all the ovaries analyzed. They were found mostly among cells covering the gonad. Basing on the difference in their size, shape of nucleus and cytoplasm gonocytes were divided into older ones and younger ones. In the ovaries of fetuses, as early as the 14th week of the intrauterine life, oogonia were observed. Their fairly regular shape, abundance of cytoplasm and large nucleus, often with nucleolus, made their observation possible even in light microscopy. In the cytoplasm of regularly differentiating oogonia organelles were more numerous than in gonocytes. Oocytes constituted a more differentiated form of germ cells. In comparison to the cells surrounding them, they had a larger size, were rounded in shape and had a centrally located nucleus. In the cytoplasm separated into the surrounding space was observed. In a large number of different germ cells signs of degeneration were found. The study has confirmed that irrespective of the duration of pregnancy, all forms of germ cells are present in the fetal ovaries and that the differentiation continues throughout the whole period of intrauterine life.

Histochemistry of hormonally active ovarian tumors

Thirty-five ovarian tumors were examined (7 granulosa-cell tumors, 2 thecomas, 4 dysgerminomas, 6 mucinous cystadenomas, 10 serous cystadenomas, 2 adenocarcinomas, 3 Krukenberg tumors and 1 early embryonic tumor). The granulosa-cell tumors showed high activity of alpha-glycerophosphate dehydrogenase, and the changed cells of their stroma--that of glucose-6 phosphate and isocitrate dehydrogenases. The activity of the latter enzymes was striking also in thecomas. Dysgerminomas showed high alkaline phosphatase, acid phosphatase and nonspecific esterase activities. The authors emphasize the role of stromal cells in the hormonal activity of ovarian neoplasms.