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J Danko

Publications and source records attributed to J Danko.

At least 19 recordsLinked to original sources

Uterine activity and ductus venosus flow velocity patterns during the first stage of labor.

OBJECTIVE: To analyze the effects of uterine contractions on ductus venosus (DV) pulsatility during the first stage of labor. METHODS: Twenty healthy women were examined. Measurements were taken at three stages of cervical dilatation (<4 cm, 4-7 cm and >or=8 cm) during and between contractions. Peak velocity during ventricular systole (S) and atrial contraction (A), pulsatility index for veins (DV PIV), ductus venosus index (DVI) and the S/A ratio were measured. RESULTS: The DV was observed successfully in 16 cases. The mean S velocity did not change significantly (64 cm/s during and 65 cm/s between contractions). The mean A velocity decreased significantly from 35 cm/s measured between contractions to 29 cm/s during contractions (P<0.0001). The mean DV PIV and DVI were significantly higher during contractions (0.72 and 0.55) than between contractions (0.57 and 0.45) (P<0.0001). There were no significant differences in means between stages of cervical dilatation. CONCLUSION: Significant differences during and between uterine contractions can be observed in DV pulsatility during normal labor.

Adult↗

Rapidly growing nodular pseudoangiomatous stromal hyperplasia of the breast in an 18-year-old girl.

Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a rare benign proliferation of mesenchymal stromal cells with irregular slit-like formations resembling angiomatous structures. In the majority of cases this lesion is a focal microscopic finding in breast biopsies performed for benign or malignant diseases. It may present in a pure diffuse or nodular form. The exact etiology and pathogenesis of this tumor-like lesion is still unknown, but a proliferative response of myofibroblasts to hormonal stimuli has been postulated. A large 12 x 9 x 3.5 cm rapidly growing nodular form of PASH of the breast in an 18-year-old woman is here described with clinical and histological findings. A possible hormonal etiology was indicated by elevated progesterone (three-fold) and decreased estrogen serum levels. Different diagnostic lesions, such as giant fibroadenoma and low-grade angiosarcoma, are discussed. To the authors' knowledge this is only the fourth case of nodular PASH of the breast reported in the English literature.

Adolescent↗

HER-2 [Ile655Val] polymorphism in association with breast cancer risk: a population-based case-control study in Slovakia.

Breast cancer belongs to the most frequent types of cancer affecting women and it occurs at any age. Around 1600-1800 women are getting ill annually in the Slovak republic. One of the most important factors in connection with cancer genesis refers to changes in specific genes. HER-2 proto-oncogene belongs to low penetrating genes, which increase susceptibility to breast cancer genesis. Clinical studies demonstrated an association between polymorphism at codon 655 of this gene and increased risk for breast cancer development. The aim of this case-control based prospective study was to determine the distribution of HER-2 genotype and its association with risk factors of breast cancer in the population of women in Slovak republic. HER-2 genotypes were determined with PCR-RFLP method. The DNA was isolated from white blood cell nuclei. The frequency of Val allele in the cancer group was 29.79% and was higher than in the control group 15.84% (p<0.05). The presence of the heterozygote (Ile/Val) genotype was identified in 46.81% of patients in the case group and in 28.33% in healthy individuals, and the homozygote (Val/Val) genotype in 6.38% and 1.67, respectively (p<0.01). The risk of breast cancer development for carriers of one valine (Val) allele in genotype was two-times lower (OR=2.47) than for carriers of two Val alleles (OR=5.73) (p<0.05). Risk of cancer genesis for Val allele carriers was higher in multiparas (OR=2.90), among women with positive family history of breast cancer (OR=5.0), BMI>24 (kg/m2), and late menopause (OR=1.5). Contraceptives in anamnesis contrariwise showed tend to decrease the risk in Val allele carriers (OR=0.3). In conclusion, this study revealed relatively high frequency of the Val allele among the women population of the Slovak republic. Ile655Val polymorphism of HER-2 gene was associated with a statistically significantly increased risk of breast cancer all above in homozygotes for Val allele.

Adult↗

[Velocimetry of the ductus venosus in the first stage of labor].

OBJECTIVE: To assess feasibility and physiological variation of fetal ductus venosus Doppler velocimetry during the first stage of labor between uterine contractions. STUDY DESIGN: A prospective cross-sectional study including 23 healthy women with low-risk pregnancies. Maximum velocities during ventricular systole (S) and atrial contraction (A) were recorded in the ductus venosus between contractions. Pulsatility index for veins (DV PIV) and the ductus venosus index (DVI) were also calculated. SETTING: Department of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University, Martin. RESULTS: Acceptable ductus venosus waveforms were acquired in 19 fetuses (83%). The mean +/- SD values of the ductus venosus index and the pulsatility index were 0.46 +/- 0.07 (95% CI: 0.42-0.49) and 0.57 +/- 0.12 (95% CI: 0.51-0.63), respectively. The mean +/- SD values of maximum velocities during ventricular systole (S) and atrial contraction (A) were 65 +/- 8 cm/s and 35 +/- 5 cm/s, respectively. CONCLUSION: Ductus venosus blood flow velocities can be assessed during labor. This calls for an extension of the detection possibilities of intrauterine fetal status and gives an idea to establish reference ranges for these circulation parameters during labor in the future.

Blood Flow Velocity↗

[Laparoscopy in chronic pelvic pain--a prospective clinical study].

OBJECTIVE: The aim of this study was to analyze the incidence, causes and management in women with chronic pelvic pain and to evaluate the role of laparoscopy. DESIGN: A prospective non-randomized clinical trial on 86 women with chronic pelvic pain. SETTING: Clinic of Gynecology and Obstetrics, JMF CU Martin, Slovak Republic. METHODS: A prospective clinical trial was performed on 86 patients with chronic pelvic pain, who have undergone laparoscopy from March 2003 to March 2004. Only patients with a pain history of at least 6 month were enrolled into this trial. Specific patient's history characteristics, laparoscopic and cytologic findings were reviewed and analyzed (pain interval, organic findings, preoperative ultrasound examination, previous surgical intervention, oral contraceptive usage, patient's medical history, menstrual cycle regularity, age, presence of dysmenorrhea). In all women, laparoscopy was performed under general anesthesia. RESULTS: During the study we have performed 309 diagnostic laparoscopic examinations, from which 86 (27.8%) were done due to chronic pelvic pain. The mean patient's age was 35.8 years (19-56). The mean parity was 1.6, ranging from 0-5. Pelvic organ pathology was present in 88.4% of the patients. The most frequent finding was endometriosis (31.4%). According to revised criteria of the American Fertility Society the presence of first, second, third and fourth stage of endometriosis was 55.6, 25.9, 11.1 and 7.4%, respectively. The most frequent occurrence of endometriotic lesions were on ligamenta sacrouterina (21.4%) and plica vesicouterina (19.0%). Pelvic adhesions, myomas, pelvic varicosities and chronic inflammatory process were present in 25.6, 15.1, 9.3 and 3.5% of the cases, respectively. No somatic origin of pain was identified at laparoscopy in 11.6% of patients. Preoperative ultrasonic examination with pelvic pathology findings were performed in 36 patients, and laparoscopy correlated with ultrasonographic findings in 31 (86.1%) cases. The average pain duration was 11.5 months (6-28) with the majority among women with history of previous surgical intervention (48.8%) and parturated women. Presence of pain was most common among women after 31 years of age. Predominantly, cytology examination of biological materials (peritoneal fluid, cyst fluid) revealed an increased histiocytic reaction in coincidence with chronic inflammation process in 31.6%. CONCLUSION: Invasive laparoscopy in chronic pelvic pain pertains to one of the most important examination procedures for its high specificity and sensitivity. Laparoscopy can reveal organic causes of pelvic pathology in 60% of cases with the possibility of following treatment. Our combined effort should stop the progression of such pathology leading to possible morphologic, functional and psychological alteration, especially among young women in fertile age. Today, endometriosis still remains the main cause of chronic pelvic pain in high percentage rate.

Adult↗

Histochemical study of innervation and NADPH-D activity of the thymus.

Acetylcholinesterase (ACHE)-positive nerve fibres in the thymus of the rat form perivascular plexuses as well as free ACHE-positive nerves, which do not follow the course of the vessels. A higher number of ACHE-positive nerves was observed in corticomedullary border and the medulla, a lower number in the cortex of the thymus lobuli. A gradual reduction of ACHE-positive intrathymus nerve formation was recorded and correlated with the increasing age of the rats. Nicotinamide adenine dinucleotide phosphate-diaphorase positive cells observed in the rat thymus were irregular with numerous projections and were located on the boundary of the cortex and medulla.

Acetylcholinesterase↗

[Morbidity after cesarean section].

OBJECTIVE: To determine the frequency, spectrum of indications and complications and maternal morbidity rate connected with Caesarean sections as the most frequent mode of operative delivery. DESIGN: Retrospective, epidemiologic and comparative clinical study. SETTING: Department of Obstetrics and Gynecology, Jessenius Medical Faculty, Comenius University, Martin, Slovak Republic. METHODS: The authors retrospectively analyzed clinical data during a ten-years period. The number of deliveries, premature deliveries, frequency of Caesarean section, indications and maternal morbidity rate were determined. Further, a special attention was paid to premature deliveries and the related frequency of Caesarean sections and maternal morbidity rate in this group. In addition, the effectiveness of a complex pre-operative management was evaluated. RESULTS: The evidence shows that the natality rate is decreasing and the incidence of premature deliveries is increasing. The frequency of Caesarean sections is relatively stable with lower morbidity rate in the group of premature Caesarean deliveries. The positive effect of antibiotics, heparin and anti-aspiration medication within a complex pre-operative management was proved to decrease the frequency and severity of complications. CONCLUSIONS: The maternal morbidity rate following Caesarean delivery is relatively low, owing to the use of prophylaxis. However, it is vital to keep to the indications for Caesarean termination of the pregnancy, because there is still substantial mortality rate connected with it.

Cesarean Section↗

Complications of video-mediastinoscopy--successful management in four cases.

The authors describe complications of video-mediastinoscopy in a number of clinical cases and present case reports of four patients, where this complication occurred. The following types of complications were recorded: one case of esophageal perforation, one case of tracheal lesion and two cases of massive bleeding from central greater vessel. Possibilities of treatment methods of these complications, possible ways how to manage and decrease the incidence of life-threatening complication are being discussed in this paper. (Fig. 5, Ref. 9.).

Brachiocephalic Trunk↗

Candida-associated denture stomatitis.

Candida-associated denture stomatitis was demonstrated by its cultivation in 171 out of 240 patients examined with partial or total dentures. After taking smears from lesions of the oral mucosa (tongue, cheeks, palate) and the contiguous denture surface by cotton wool swabs and inoculating them onto Sabouraud glucose agar and CHROMagar Candida, individual yeast species were identified by a germ tube, filamentous, and assimilation tests employing the commercial kit AuxaColor. Seven Candida species were identified in smears from the oral mucosa lesions and the contiguous denture surface: C. albicans (95 patients), C. tropicalis (26), C. parapsilosis (20), C. krusei (14), C. guilliermondii (12), C. lusitaniae (1) and C. freyschusii (1). Diabetes mellitus, neoplastic diseases, chemotherapy, radiotherapy, and broad-spectrum antibiotic therapy were identified as some of the large number of factors predisposing patients to stomatitis prothetica.

Aged↗

The histopathological characterization of oral Candida leukoplakias.

Sixty four biopsy specimens of oral Candida leukoplakias were examined. Histological sections were stained with periodic acid-Schiff (PAS) reagent and by Grocott's silver method. C. albicans isolates were cultivated from all the patients but fungal hyphae were proved histologically only in 23 of them. PAS-positive and Grocott-positive elements were exclusively observed in the superficial epithelial layers, e.g., the cornified layer and the stratum granulosum. The inflammatory reaction was characterized by an early phase during which polymorphonuclear cells predominated. The skeletal muscle fascicles immediately adjacent to the infected epithelium showed striking degeneration and atrophy associated with a marked infiltrate of chronic inflammatory cells.

Aged↗

Electrophoretic karyotyping of Candida albicans strains isolated from premature infants and hospital personnel in a neonatal intensive care unit.

Electrophoretic karyotyping was used to compare DNA probes of yeasts isolated from blood of preterm neonates (n = 66) in a neonatal intensive care unit (NICU) and from the hands of healthy hospital personnel (n = 10). The yeasts were identified as Candida albicans using standard laboratory methods. DNA was extracted from yeasts and isolation of identical DNA strains from the pairs nurse-neonate suggested that one nurse transmitted one yeast strain by her hands to three neonates. Four neonates harbored two identical strains originating from two nurses, i.e. each nurse transmitted the same strain to two neonates. In the additional 7 cases transmission of 1 yeast strain by 1 nurse to 1 neonate was observed. Our data suggest that nonperinatal nosocomial transmission of C. albicans occurs in neonates, possibly via cross-contamination being transferred on hands of health care workers. The importance of careful hand washing of staff (health care workers) and other infection-control procedures (to prevent the nosocomial transmission of pathogens in the NICU environment) is emphasized.

Candida albicans↗

Cutaneous candidosis in immunosuppressed patients.

One-hundred patients with candidosis of the skin, mucous membranes and nail plates (confirmed by cultivation) were examined. Topical or systemic antimycotic treatment was successful in 58 patients. After a complete evaluation, 42 patients were found to suffer from factors supporting candidosis--diabetes mellitus (12), anemia (3) and various local factors (10 patients); 27 patients showed a deficiency in cell-mediated immunity. In addition to intensive antimycotic therapy, successful treatment is affected by the actual immunity level and can be ensured by efficient immunomodulation treatment of immunodeficiency.

Antibodies, Fungal↗

Yeast-like microorganisms in eye infections.

The proportion of yeast species involved in eye infections in 11 patients was examined. The presence of yeast organisms as causative agents of endophthalmitis was found in corneal smears (n = 4), conjunctival swabs (4), and vitreous fluid (3). Altogether 5 strains of Candida albicans, 2 strains of C. krusei and one strain each of C. guilliermondii, C. parapsilosis, C. tropicalis and Cryptococcus neoformans were isolated from the clinical material. The hematogenic origin of endophthalmitis was proved in 7 cases on the basis of positive blood samples and in 2 cases by the isolation of yeasts from the tip of an intravenous catheter. Endophthalmitis-supporting risk factors such as indwelling intravenous catheters, prolonged use of broad-spectrum antibiotics and chemotherapy, surgical intervention, diabetes mellitus, and malignancy were observed in the patients.

Candida↗

Candidaemia in cancer patients and in children in a neonatal intensive care unit.

The species most frequently found in the group of neonates was C. parapsilosis, its incidence reaching 48%. Other yeasts isolated from blood were C. albicans (41%), C. tropicalis (7%), C. krusei and C. pseudotropicalis (2% each). Six yeast species (C. albicans 44%, C. parapsilosis 28%, C. tropicalis 11%, C. krusei 8%, C. guilliermondii 6%, C. lusitaniae 3%) were detected in cancer patients. The presence of an intravenous catheter as a possible risk in the development of candidaemia was identified in all neonates and in 69% of cancer patients. C. krusei candidaemia was associated with prophylactic fluconazole therapy.

Adolescent↗

[Epidural obstetrical analgesia and cardiotocography].

OBJECTIVE: The increase of cardiotocographic abnormalities, such as late decelerations, bradycardia and reduced variability have been reported with epidural analgesia (EDA) in some studies. The aim of our study was to assess the influence of epidural analgesia on the incidence of the pathological cardiotocographic patterns. DESIGN: A clinical study. SETTING: Department of Obstetrics and Gynaecology, Jessenius Medical Faculty of Comenius University, Martin, Slovak Republic. METHODS: Clinical group consists of 200 parturients, who borne in our department from 1997 to 2000. The epidural group of parturients (n = 100) borne under epidural analgesia, the control group of (n = 100) borne under other resp. no analgesic method. We compared BFHR, variability and the incidence of accelerations and decelerations in CTG between both groups. All cardiotocographic patterns were evaluated by Fischer score. For statistic evaluation was used Student t-test. RESULTS: We did not find any statistically significant differences in Fischer score between epidural and control group. CONCLUSION: The epidural labour analgesia is safe method of ease pain during labour. In our study we confirmed, that EDA is not responsible for the increase of pathological cardiotocographic patterns.

Analgesia, Epidural↗

Rare non-albicans Candida species detected in different clinical diagnoses.

In working on the incidence of yeasts we excluded from the tested set C. albicans, C. krusei, C. parapsilosis and C. tropicalis on the basis of morphological and biochemical properties. We found 16 rare species of yeasts: C. claussenii (16), C. guilliermondii (10), C. robusta (9), C. pulcherrima (8), C. zeylanoides (4), C. glabrata (3), C. lusitaniae (3), C. catenulata (2), C. mesenterica (2), C. utilis (2), C. freyschussii, C. intermedia, C. kefyr, C. lipolytica, C. mogii, C. pseudotropicalis (1 for each). These yeasts were detected mainly in cases of premature babies (22) from the nasopharynx (13), from the rectum (4), from the skin (23), from wound drains and from blood (1 for each), with gynaecological diagnoses (15) and rarely other diagnoses, such as malignancy (5), hypertension and respiratory infections (4 for each), kidney transplantation (3), dialysis, haemolytic-uremic syndrome (2 for each), perforation of gastric ulcus, otitis, prostatitis, ulcus cruris, coma, spina bifida, peritonitis and hepatic failure from different clinical material.

Candida↗

Prevalence of Cryptococcus neoformans in clinical specimens.

Cryptococcus neoformans isolated from various clinical materials in 14 cases, was identified by (1) cultivation on Sabouraud glucose agar and CHROMagar Candida, (2) microscopic examination of Indian-ink-stained preparations and (3) determination of biochemical properties (assimilation and fermentation of saccharides, assimilation of KNO3, production of urease and phenol monooxygenase). C. neoformans was determined in five specimens from paediatric patients in the intensive care unit and in nine specimens from adult patients, most frequently from liquor at meningitis (n = 3).

Adult↗

Relative pathogenicity of Candida tropicalis in rat tongue mucosa.

The potential of C. tropicalis to colonize and infect rat tongue mucosa was demonstrated. Thirty female Sprague-Dawley rats were infected orally with three different strains of C. tropicalis. The animals were killed one and three weeks following the inoculation and sections of their tongue were stained with hematoxylin-eosin and Grocott stain. Histological changes were observed in the group of animals killed one week after inoculation and infected with C. tropicalis strain isolated from the crural ulcer of a diabetic patient. The most important finding was acute purulent myositis with the formation of abscesses. The myositis was local without signs of spreading to the surrounding tissue. Epithelium-penetrating hyphae observed in the Grocott-stained sections were relatively fewer and more sparsely distributed.

Abscess↗