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Branka Nikolić

Publications and source records attributed to Branka Nikolić.

8 recordsLinked to original sources
PubMed2006

Pregnancy using gonadotropins and performing intrauterine insemination in a woman with hypogonadotropic hypogonadism.

Hypogonadotropic hypogonadism is one of the causes of infertility. In women with hypogonadotropic hypogonadism both follicle-stimulating hormone and luteinizing hormone are required to induce optimal follicular growth and steroidogenesis. We described a case of singleton pregnancy in a 38-year-old patient, presenting with primary hypogonadotropic amenorrhea and empty sella syndrome, treated with human menopausal gonadotropins and performing intrauterine insemination in first attempt. This therapy led to maturation of two follicles and one of them was fertilized. A singleton pregnancy ensued and a normal infant was delivered by cesarean section.

Adult↗
PubMed2006

Mean of CA 125 in making therapy decision in adnexal inflammatory tumors.

UNLABELLED: LABORATORY FINDINGS such are white blood count and sedimentation rate are of relative value in inflammations of the upper genital tract and adnexal inflammatory tumors. Antibiotics are administrated in all cases according to the protocol but some of them need operative treatment also. Inflammatory tumors can develop in endometriotic and even in cancer adnexal masses. CA 125 is elevated in great number of patients with advanced ovarian cancer. It can also be elevated in endometriosis, inflammations and in non-gynecological malignancies. Adnexal inflammatory tumor was confirmed in 57 patients. LABORATORY FINDINGS: white blood count and sedimentation rate were in normal levels in 17 patients. CA 125 was elevated in 27 patients. 49 patients were operated and CA 125 decreased in the first 5 days after the operation. Only 8 patients without CA 125 elevation were successfully treated by mean of antibiotics. Even there is no need for routine examining of serum CA 125 in adnexal inflammatory tumors it can be examined in cases with suspected Doppler ultrasonographic findings or unclear clinical findings. Endometriosis brings some risk of malignancy. Inflammatory tumor can develop in endometriotic tumor as well as in necrotic malignant ovary tissue. These could be reasons for making decision to do the operation in cases with inflammatory tumor followed with increased CA 125, hystological assessment and serious interpretation of final results.

Adnexal Diseases↗
PubMed2006

Hyperbaric oxygenation as a possible therapy of choice for infertility treatment.

Endometrial sonographic and color doppler features can be used to predict the occurrence of pregnancy in natural or stimulated cycles. Implantation will usually only take place if the endometrium has reach a certain stage of vascularisation and development. The aim of this study was to evaluate endometrial development -- endometrial thickness and reflectivity , subendometrial, endometrial and uterine perfusion, after hyperbaric oxygenation, using transvaginal color doppler. During a three years period 32 women with unexplained infertility were entered into a randomised study. The patients were treated in multiplaced HAUX chamber at pressure of 2.3 ATA during 70 minutes, 7 days consecutively beginning with day 5th of menstrual cycle. The evaluation of effects of hyperbaric oxygen therapy was carried out by transvaginal color doppler sonography which was continuously used starting from 8th day of menstrual cycle until the ovulation in the cycles when the therapy was applied , one month before and one month after the therapy. Folliculometry in the cycles when hyperbaric oxygen therapy at 2.3 ATA was applied, indicated an excellent response of endometrium. Thickness of endometrium at the time of ovulation was 11.0 +/- 2.6 mm. Desirable quality of endometrium was significantly better in the cycle when HBO therapy had been applied (p< 0.001). The doppler flowmetry of the uterine arteries indicated that the uterine blood vessel resistance was slightly higher than expected. Mapping of subendometrial blood vessels in the cycles covered by hyperbaric oxygen therapy showed the intensive capillary network of endometrium with low resistance Ri< 0.45. The oxygen used under higher pressure -- oxygen as a drug , may have an extraordinary significance for better outcome of pregnancy implantation by improving endometrial receptivity. If endometrial receptivity is conditioned by adequate vascularisation and oxygenation, then hyperbaric oxygen therapy is the treatment of choice.

Adult↗
PubMed2006

[Tumor marker CA-125 in adnexal inflammatory tumors].

BACKGROUND/AIM: The glycoprotein of a high molecular weight CA-125, which is not a specific tumor marker of ovarian cancer, is secreted by the endothelial cells of most pelvic organs. Endometriosis, inflammatory processes in the pelvic cavity, as well as some nongynecoligical malignant diseases, could be followed by the increased values of CA-125. Serial assessment of the values of CA-125 makes it possible to avoid surgical treatment, and, by means of the used conservative treatment, to avoid malignant diseases not to be noticed. METHODS: The study included 57 female patients hospitalized due to inflammable adnexal tumors. Besides following the values of serum CA-125 during and after the therapy, also performed were the transvaginal Doppler ultrasonography and the determination of the values of resistance index (RI). RESULTS: In 27 patients (55.1%) the CA-125 values ranged from 38.8 U/ml to 794 U/ml, while in 30 of the patients they were within the range of normal. In this group of the patients, besides the increased values of CA-125, also increased were the values of leucocytes (11(9)/1-20(9)/1), as well as the sedimentation rates (65-120) within the first hour. In all the 57 patients, transvaginal Doppler ultrasonography revealed the presence of adnexal tumor of inflammatory kind. The measured values of RI were within the range of 0.539-0.681. Eight of the patients were treated by the conservative--triple antibiotic therapy, while in 49 patients explorative laparotomy was performed. Hystorectomy was done in 12 of the patients, and one-side adnexectomy in 37 of them. CONCLUSION: The method for the assessment of CA-125 is simple and available which facilitates the monitoring of surgical, conservative or the combined therapy that is particularly significant in younger patients with inflammable adnexal tumor developed on the basis of endometrosis.

Adult↗
PubMed2006

[Case report of ultrasonographic findings in developing choriocarcinoma].

INTRODUCTION: Gestational Trophoblastic Neoplasm (GTN) develops from fetal tissue with risk of malignancy after complete hydatidiform mole of 20%. MATERIAL AND METHODS: This is a case report of progressive destruction of uterine tissue in 43 years old patient caused with developing Choriocarcinoma three months after legal abortion. Severe changes in uterine structure as multiple anechogenic foci of destruction were found during transvaginal Doppler ultrasound examination. Hypervacularisation in malignant trophoblastic tissue with low Resistance index values (0,397-0,471) were also detected during transvaginal Doppler ultrasonography. Ultrasonographic picture significantly changed in two months followed with serum human chorionic gonadotropine increasing rate. Operative treatment performed and polychemotherapy administrated. Postoperative hystological examination confirmed Choriocarcinoma. DISCUSSION: The most relevant parameter in making GTN diagnose is serum human chorionic gonadotropine level. This case of choriocarcinoma showes that ultrasonographic changes can sometimes bee more progressive than expected value of serum hCG according to those findings. Transvaginal Doppler ultrasonographic findings must be compared with changes in serum human chorionic gonadotropine values and hystological findings. CONCLUSION: Choriocarcinoma is not easy to detect ultrasonographicaly but in some cases ultrasonographic picture can be specific for the case as one of numerous ultrasonographic models choriocarcinoma can appear in.

Adult↗
PubMed2005

[Significance of transvaginal Doppler ultrasonography for detection of malignant gestational trophoblastic disease].

Transvaginal Doppler ultrasonography has an important role in detecting and confirming the gestational trophoblastic disease (GTD). It can also be helpful in early detection of the malignant cases of GTD such as the invasion and protrusion of trophoblastic tissue into the uterine wall. Ultrasonographic picture of the malignant GTD is also specific for the presence of prominent zones of vasculavization in the peritrophoblastic tissue, as well as in the uterine tissue in which malignant GTD is developed. Resistance Index (RI) values were measured at the level of blood vessels of peritrophoblastic tissue and of suspected zones in the uterine tissue to detect neovascularization, which followed the malignant process. Theca luteal cysts were often detected by Transvaginal Doppler ultrasonography.

Female↗