[Co-existence of reduced femur neck density and reduced skin thickness]

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.

[Uterine corpus extension of primary cervical carcinoma IIA-IIB. The compatibility of preoperative and postoperative diagnosis and its annual significance]

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.

[Uterus corpus extension of primary cervical carcinoma IIA-IIB]

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.

[The value of skin densitometry in diagnosis of decreased bone mass in the spine of women during the period around and post-menopause]

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.

[Comments on reconstruction after postcricoid carcinoma surgery]

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.

[Primary carcinoma of the fallopian tube: a clinicopathological study of 11 cases]

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.

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]

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]

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%.

[The evaluation of endometrial invasion of cervical Ib grade carcinoma]

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]

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]

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]

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.

[Laparoscopic image of pelvic minor organs in women after ovary surgery]

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]

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.

[Balneologic rehabilitation in women operated on for ectopic tubal pregnancy]

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]

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%.

[Diagnostic methods considering tubal factors in infertility]

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.

[Fertility of women after past ectopic pregnancy]

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.

[Psychophysical examinations of adolescent girls with neoplastic diseases during puberty after multidrug chemotherapy]

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.

[Value of vascular resistance in fetal circulation during normal pregnancy]

The aim of the study is to estimate the values of resistance index (RI) in the arteries of the fetus using color doppler ultrasound. Measurements have been made in aorta, umbilical and medial cerebral artery of the fetus and in arcuate artery of the pregnant women. 50 women have been examined every 4 weeks and another 50 every 6 weeks during normal pregnancy. Resistance index has been calculated based on analyses of flow waves configuration in all of the mentioned arteries. Likeness between curves obtained in women examined every 4 and 6 weeks in obvious. The examination of mean RI values shows that vascular resistance in descending aorta remains constant during the vascular resistance in descending aorta remains constant during the all the period. In arcuate artery vascular resistance falls down until 22 week of pregnancy and then settles on constant level. RI of umbilical artery decreases during pregnancy and in median cerebral artery reaches its peak in 32/34 week of pregnancy.

[Role of pelvic endoscopy in diagnosing congenital uterine malformations]

The role of pelvic endoscopy in diagnosing uterine abnormalities, considering material of 1170 patients, is presented in this paper. It has been documented that pelviscopy together with hysterosalpingography play basic role in determining type of uterine abnormality. In 20 cases pelvic endoscopy enabled verification of the primary diagnosis set by hysterosalpingography. Pelvic endoscopy is a method by choice in the diagnostics of the Rokitansky-Küster-Hauser syndrome.

[Pelvic endoscopy in diagnosing fallopian tube disorders that cause infertility]

Over the period of 25 years, 1080 pelvic endoscopy in infertile women were performed, with special attention payed to the pathology of Fallopian tubes. Pelvic endoscopy was performed after previous HSG. During the pelvic endoscopy, the state of the uterus, ovaries and uterine tubes were evaluated, with much attention paid to the condition of the abdominal ostium of the uterine tube, symptoms of active and chronic inflammation, endometriosis, the authors also tried to diagnose the extension and character of pelvic-salpingian adhesions. Confrontation of the results enabled diagnosis in 111 (41.7%) women, out of 266, with patient Fallopian tubes the organic factors which impaired conception or made conception impossible. In the group of 814 women with tubal impotency in 15 (1.8%) cases extratubal factor was found, subserosal myoma in uterine horn, cyst, adhesions, while Fallopian tube itself was patent and unchanged. Organic factors of Fallopian tube disorder were determined. In 360 (44.2%) patients, out of 814, with tubal impotency pathological status was found (active salpingitis, tuberculosis, endometriosis) which required establishing of a necessary treatment and cancelling the surgical treatment.

[Cytogenetic studies of families with reproductive failure]

Cytogenetic analysis carried out in 209 patients with reproduction failure demonstrated chromosomal aberrations in 6 married couples. In 5 of these cases balanced translocations were found, and in one case 45,X/46,XX cell mosaicism was present. The proportion of abnormal karyotypes in the group was 5.7% per one couple and was only slightly lower than the mean frequency of chromosomal aberrations calculated by the authors in cases of reproduction failures diagnosed in other cytogenetic laboratories in Poland-6.7%. The identical frequency of aberrations in married couples with a history of 2 or 3 or more abortions indicates the necessity of carrying out cytogenetic investigations already after two spontaneous abortions.

[Studies on the incidence and possibility of collective treatment of certain non-occlusal parafunctions in elementary school children]

A study was carried out on the incidence and possibility of collective treatment of non-occlusal parafunctions in 216 elementary school children aged 7-14 years. Two objectively detectable non-occlusal parafunctions were analysed: nail-biting and pencil-biting. The study included four meetings during which the fingernails and pencils were inspected in all children and a talk was given, explaining the harmfulness of motor habits in the masticatory system, and the children with these habits were told to replace them with other non-harmful movements as habits. Among 216 children 131 (60.6%) had such non-occlusal parafunctions with nail-biting in 51.9% of them, and pencil-biting in 31%. In 22.2% both habits were found. During the third control visit the overall incidence of both parafunctions was found to be decreased, from 60.6% to 37.9%. Elimination of nail-biting was obtained in 37.5% of cases, and pencil-biting in 64.2%, with the proportions of treated children varying in various classes. The study showed that nail-biting and pencil-biting are widely spread habits in the studied population and that collective treatment of these parafunctions is possible.